Individual provider Active NPI

Mia T. Chandler, M.D., M.P.H.

  • Pediatric Rheumatology Physician
  • Winston Salem, NC
National Provider Identifier
1982021341
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X
License
271359 Issued in MA
Practice address
Medical Center Blvd
Winston Salem, NC 27157-5724
Phone
(336) 713-4500
Fax
(336) 713-4501
NPI assigned
Mar 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rheumatology Physician 2080P0216X 271359 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-5724

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 713-0947

Other practice location 1

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6117

Other names 1

  • Mia Vatrice Taylor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171010000945 MA Practitioner - RheumatologyPractitioner - Pediatric Medicine 0840417598 Reassigns benefits to 2 organizations
I20250430000605 NC Practitioner - Pediatric Medicine 0840417598 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Jun 2, 2025 Accepting new patients
Holyoke Pediatric Associates, LLP Pediatrics CurrentSince Sep 3, 2017 Accepting new patients
Children'S Hospital Pediatric Associates, Inc Pediatrics CurrentSince Jul 1, 2023 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

150 Lower Westfield Rd
Holyoke, MA 01040
Phone (413) 536-2393

84 Willimansett St
South Hadley, MA 01075
Phone (413) 533-8501

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: mchandler27957@direct.bostonchildrens.org
  • Direct secure messaging: mchandler3011144@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1982021341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-713-0947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271575724",
            "telephone_number": "336-713-4500",
            "fax_number": "336-713-4501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "MIA",
        "middle_name": "T.",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-24",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "MA",
            "license": "271359",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "TAYLOR",
            "middle_name": "VATRICE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.