DR. PAUL CHACKO (NPI# 1932253200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932253200 |
| Entity Type | Individual |
| Full Name | DR. PAUL CHACKO |
| Credential | M.D. |
| Practice Address |
1722 Shaffer St Kalamazoo MI 49048-1633 |
| Mailing Address |
25195 Kelly Rd Ste A Roseville MI 48066-4909 |
| Practice Telephone | (269) 381-3963 |
| Mailing Telephone | 5867754594 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2019-01-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
4301113018 | MI | Allopathic & Osteopathic Physicians |
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
4301113018 | MI | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 456 W 10th Ave, 4980 Cramblett Hall, Columbus, OH 432101240 | 6142937499 | 6142932360 |
| Street Address |
1722 SHAFFER ST |
| City | KALAMAZOO |
| State | MI |
| Zip Code | 49048-1633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194700104 | Anthony King | Internal Medicine | 1722 Shaffer St, Suite 1, Kalamazoo, MI 49048-1633 | 2005-12-13 |
| 1588916316 | Rebecca M Blades | Nurse Practitioner | 1722 Shaffer St, Kalamazoo, MI 49048-1633 | 2012-10-03 |
| 1720355910 | Spectrum Health Primary Care Partners | Pediatrics | 1722 Shaffer St, Suite 3, Kalamazoo, MI 49048-1633 | 2011-11-16 |
| 1275840969 | Gerard Joseph Gole | Physician Assistant | 1722 Shaffer St, Ste #1, Kalamazoo, MI 49048-1633 | 2010-09-02 |
| 1366769747 | Jessica Delois Williams | Internal Medicine | 1722 Shaffer St, Kalamazoo, MI 49048-1633 | 2010-04-26 |
| 1215167838 | Deepthi Rao | Internal Medicine | 1722 Shaffer St, Kalamazoo, MI 49048-1633 | 2009-07-16 |
| 1831334762 | Sandra Lynn Pratt | Nurse Practitioner | 1722 Shaffer St, Heart Failure Clinic At Borgess, Suite 3, Kalamazoo, MI 49048-1633 | 2008-12-05 |
| 1295995876 | Jamie B Simpson | Psychologist | 1722 Shaffer St, Kalamazoo, MI 49048-1633 | 2008-06-17 |
| 1831398379 | Paulette Levy Thompson | Social Worker | 1722 Shaffer St, Kalamazoo, MI 49048-1633 | 2007-07-14 |
| 1134322308 | Mauli Ashish Verma | Psychiatry & Neurology | 1722 Shaffer St, Suite 3, Kalamazoo, MI 49048-1633 | 2007-06-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790214146 | Sally Leigh Weigandt | Technician, Other | 5438 Lucerne Ave, Kalamazoo, MI 49048 | 2017-06-08 |
| 1437606670 | Amanda Ezekiel | Advanced Practice Midwife | 1523 Gull Rd Ste 250, Kalamazoo, MI 49048 | 2016-09-06 |
| 1700238987 | Brittany Bittenbender | Technician, Other | 5840 E Cork St, Kalamazoo, MI 49048 | 2016-07-12 |
| 1255747176 | Araena Payton | Early Intervention Provider Agency | 1313 Hotop Ave, Kalamazoo, MI 49048 | 2014-07-11 |
| 1508297151 | Hope Network Eastwood House | Residential Treatment Facility, Physical Disabilities | 2236 Brook Drive, Kalamazoo, MI 49048 | 2013-12-09 |
| 1457780314 | Hope Network Rehabilitation Servicesq | Residential Treatment Facility, Physical Disabilities | 2236 Brooke Drive, Kalamazoo, MI 49048 | 2013-11-01 |
| 1467889576 | Aaron Van Heest | Social Worker | 813 Chrysler St., Kalamazoo, MI 49048 | 2013-10-03 |
| 1760737308 | Salem A. Salem | Internal Medicine | Ascension Borgess Hospital, 1521 Gull Rd, Kalamazoo, MI 49048 | 2012-07-19 |
| 1356523229 | Borgess Medical Center | Psychiatry & Neurology | 1521 Gull Road, Kalamazoo, MI 49048 | 2007-12-03 |
| 1629290135 | Robert Claude Gano | Dentist | 5462 Gull Rd Suite 7, Kalamazoo, MI 49048 | 2007-05-03 |
| Find all providers in zip 49048 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194700104 | Anthony King | Internal Medicine | 1722 Shaffer St, Suite 1, Kalamazoo, MI 49048-1633 | 2005-12-13 |
| 1649273855 | Umakant Shivlal Doctor | Internal Medicine | 1535 Gull Rd, Ste 110, Kalamazoo, MI 49048-1630 | 2005-05-23 |
| 1164809067 | Keith Smart | Internal Medicine | 601 John St, Kalamazoo, MI 49007-5341 | 2015-04-29 |
| 1255695987 | Ryan Jamoua | Internal Medicine | 1521 Gull Rd, Kalamazoo, MI 49048 | 2012-06-27 |
| 1366769747 | Jessica Delois Williams | Internal Medicine | 1722 Shaffer St, Kalamazoo, MI 49048-1633 | 2010-04-26 |
| 1871714915 | Brett J Eliuk | Internal Medicine | 601 John St, Suite 100, Kalamazoo, MI 49007-5341 | 2007-05-02 |
| 1770709602 | Borgess Medical Center | Internal Medicine | 1717 Shaffer St, Suite 232, Kalamazoo, MI 49048-1647 | 2007-04-18 |
| 1306976204 | Ascension Borgess Hospital | Internal Medicine | 1521 Gull Rd, Kalamazoo, MI 49048-1640 | 2007-03-07 |
| 1104952019 | Premier Cardiology PC | Internal Medicine | 1722 Shaffer St, Suite 1, Kalamazoo, MI 49048-1633 | 2007-02-26 |
| 1629165378 | Sreenivas P Kamath | Internal Medicine | 1722 Shaffer St, Suite 1, Kalamazoo, MI 49048-1633 | 2006-10-06 |
| Find all providers in KALAMAZOO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.