Individual provider Active NPI

Patrick Allan Chaney, D.D.S., M.S.

  • Oral and Maxillofacial Pathology Dentistry
  • Lima, OH
National Provider Identifier
1992733174
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
30017635 Issued in OH
Practice address
830 W High St
Suite 301
Lima, OH 45801-3971
Phone
(419) 227-5155
Fax
(419) 227-4370
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 30017635 OH Primary

Addresses

Primary practice location

830 W High St
Suite 301
Lima, OH 45801-3971

Mailing address

830 W High St
Suite 301
Lima, OH 45801-3971
Phone (419) 227-5155

Other identifiers 1

IdentifierTypeStateIssuer
0704689MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20120509000601 OH Practitioner - Oral SurgeryPractitioner - PathologyPractitioner - AnesthesiologyPractitioner - Maxillofacial Surgery 9830102326

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Anesthesiology, Maxillofacial Surgery, Pathology
Education
Ohio State University College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

830 W High St
Suite 301
Lima, OH 45801-3970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
30017635OHMDOral and Maxillofacial Pathology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company 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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992733174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 W HIGH ST",
            "address_2": "SUITE 301",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458013971",
            "telephone_number": "419-227-5155",
            "fax_number": "419-227-4370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 W HIGH ST",
            "address_2": "SUITE 301",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458013971",
            "telephone_number": "419-227-5155",
            "fax_number": "419-227-4370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANEY",
        "first_name": "PATRICK",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "OH",
            "license": "30017635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0704689",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.