Individual provider Active NPI

Nicole Chadwick, M.D.

  • Obstetrics & Gynecology Physician
  • Glendale, CA
National Provider Identifier
1982136610
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
147620 Issued in CA
Practice address
1808 Verdugo Blvd Ste 413
Glendale, CA 91208-1468
Phone
(818) 658-5980
NPI assigned
Mar 31, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 147620 CA Primary

Addresses

Primary practice location

1808 Verdugo Blvd Ste 413
Glendale, CA 91208-1468

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (818) 658-5980

Other practice location 1

1516 San Pablo St Fl 3
Los Angeles, CA 90033-5313
Phone (323) 276-3705

Other names 1

  • Evelyn Mitchell Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address evelyn.mitchell@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20190725003127 CA Practitioner - Obstetrics/Gynecology 7517293731 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Obstetrics & Gynecology CurrentSince Aug 1, 2019 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Aug 1, 2019 Accepting new patients
Keck Medical Center of Usc Past Accepting new patients
Usc Verdugo Hills Hospital, LLC Past Accepting new patients
Usc University Hospital, Inc. Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1808 Verdugo Blvd
Ste 413
Glendale, CA 91208
Phone (818) 658-5980

1808 Verdugo Blvd
Ste 412
Glendale, CA 91208

830 S Flower St
Los Angeles, CA 90017
Phone (213) 437-1007

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1516 San Pablo St
Fl 3
Los Angeles, CA 90033
Phone (323) 276-3705

Interoperability endpoints

  • Direct secure messaging: evelyn.mitchell@direct.usc.edu

Organizations & group practices 5

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": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1982136610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "818-658-5980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1808 VERDUGO BLVD STE 413",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912081468",
            "telephone_number": "818-658-5980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1516 San Pablo St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900335313",
            "country_code": "US",
            "telephone_number": "323-276-3705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHADWICK",
        "first_name": "NICOLE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "147620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evelyn.mitchell@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1808 Verdugo Blvd Ste 413",
            "city": "Glendale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "912081468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "EVELYN",
            "last_name": "MITCHELL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.