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JON BLAKE CHADWELL M.D. NPI 1255380903


NPI Information

NPI: 1255380903
Provider Name: JON BLAKE CHADWELL, M.D.
Classification: Otolaryngology - 207YX0905X
Entity Type: Individual

Specialization: Otolaryngology/Facial Plastic Surgery

PECOS Registration: Yes

Address:
6301 UNIVERSITY COMMONS
SUITE 360
SOUTH BEND, IN
ZIP 46635
Phone: (574) 232-4800
Get Directions

Jon Blake Chadwell, M.D. is an otolaryngology/facial plastic surgery otolaryngology in South Bend, IN with 24 years of experience. The provider is an otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. Jon Blake Chadwell, M.D. NPI is 1255380903. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduation Year:2000

The provider's business location address is:

6301 UNIVERSITY COMMONS
SUITE 360
SOUTH BEND, IN
ZIP 46635-571
Phone: (574) 232-4800
Fax: (574) 280-4810

The NPI 1255380903 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/9/2006 and was last updated on 3/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207YX0905XOtolaryngologyOtolaryngology/Facial Plastic Surgery01061815AINDIANAYes
2207YX0905XOtolaryngologyOtolaryngology/Facial Plastic Surgery43615COLORADONo
3207YX0905XOtolaryngologyOtolaryngology/Facial Plastic Surgery35 085143OHIONo
4207YX0905XOtolaryngologyOtolaryngology/Facial Plastic Surgery39547KENTUCKYNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
101061815AOTHERINDIANAINDIANA LICENSE
2000000485851OTHERINDIANAANTHEM PIN
3200523340AMEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.