MICHAEL JOSEPH CHISAM
NPI 1093274342
General Practice in Camp Lejeune, NC

Q: What is Michael Chisam's NPI number?

The NPI number for Michael Chisam is 1093274342. It was assigned to this individual provider in the NPPES registry on March 17, 2019.

Q: What is Michael Chisam's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Chisam was last updated on January 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 17, 2019PECOS Enrolled

100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547(757) 953-2339 Get Directions Write a Review

NPPES record last updated: January 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 11, 2022, Mar 17, 2019 (2 updates tracked since 2019).

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About Michael Joseph Chisam NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL JOSEPH CHISAM (NPI 1093274342) is an individual general practice provider in Camp Lejeune, North Carolina, licensed in North Carolina (2020-03385) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093274342

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NameMICHAEL JOSEPH CHISAM

Location Address100 BREWSTER BLVDCamp Lejeune, NC 28547-2575

Mailing AddressNaval Medical Center Camp Lejeune, 100 Brewster BlvdCamp Lejeune, NC 28547-2538

Phone(757) 953-2339

Sole ProprietorYes

Enumeration DateMarch 17, 2019

Last NPPES UpdateJanuary 11, 20222 updates tracked since enumeration

NPPES CertifiedJanuary 7, 2022

✔ NPI 1093274342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in NC · 2020-03385

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

100 BREWSTER BLVD, Camp Lejeune, NC 28547

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Joseph Chisam is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JUSTIN THOMAS DAUGHTRY D.O.

Emergency Medicine