Chance Michael McInnis

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD.207389 Issued in LA

Practice address

8643 Radcliffe Dr
Tyler, TX 75703-5220

Phone

(903) 539-6077

NPI assigned

Apr 10, 2013

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of New England, College of Osteo Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

NeurojustGroup PAC ID 7719376979, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chance.mcinnis.1@16211.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Neurojust

  • Psychiatry Physician
  • Metairie, LA
  • NPI 1528655701
  Medicare reassignment Care Compare group NPD
• Jeffcare

  • Federally Qualified Health Center (FQHC)
  • Metairie, LA
  • NPI 1518383785
  Medicare reassignment NPD
• Ria Health PC

  • Addiction Medicine (Internal Medicine) Physician
  • San Francisco, CA
  • NPI 1326539404

  LA

  Medicare reassignment NPD
• Jeffcare

  • Federally Qualified Health Center (FQHC)
  • Marrero, LA
  • NPI 1154747327
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1962845768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8643 RADCLIFFE DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035220",
            "telephone_number": "903-539-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8643 RADCLIFFE DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757035220",
            "telephone_number": "903-539-6077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "CHANCE",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-10",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "MD.207389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Robert McGough, O.D.
• Thomas Michael McGovern, MD
• Tiara Chante McGowen, NP
• Glynna Tarrant McGuffey, PT, DPT
• Lindsey McGuire, PTA
• Mary Angela McInnis, DNP, APRN, ENP, FNP
• David Douglas McIntire, R.PH.
• David Clay McIntyre, AGNP-C
• Jennifer Marie McKelva, PA-C
• Michael McKelva

• Psychiatry Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.