Active NPI
Vella V Chancellor, M.D.
- Obstetrics & Gynecology Physician
- Mansfield, TX
National Provider Identifier
1972594489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- F1443
- Practice address
- 2800 E. Broad Street
Suite 400
Mansfield, TX 76063 - Phone
- (817) 477-9292
- Fax
- (817) 473-9787
- NPI assigned
- Nov 3, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | F1443 | TX | Primary |
Addresses
Primary practice location
2800 E. Broad Street
Suite 400
Mansfield, TX 76063
Mailing address
2800 E. Broad Street
Suite 400
Mansfield, TX 76063
Phone (817) 477-9292
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00SY33 | Other | TN | BCBS |
| 035911901 | Medicaid | TX | |
| 2221774 | Other | TX | BLUE LINK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F1443 | TX | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| F. Thomas Dean, M. D. | Obstetrics & Gynecology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Obstetrics & Gynecology Physician
- Desoto, TX
- NPI 1558797290
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478044800000",
"number": "1972594489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2800 E. BROAD STREET",
"address_2": "SUITE 400",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "76063",
"telephone_number": "817-477-9292",
"fax_number": "817-473-9787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2800 E. BROAD STREET",
"address_2": "SUITE 400",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "76063",
"telephone_number": "817-477-9292",
"fax_number": "817-473-9787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANCELLOR",
"first_name": "VELLA",
"middle_name": "V",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-03",
"last_updated": "2016-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "TX",
"license": "F1443",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "00SY33",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "035911901",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE LINK",
"identifier": "2221774",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.