AVERY CAMILLE CHISHOLM MD
NPI 1558824912
Internal Medicine - Gastroenterology in Yulee, FL

Active since April 11, 2019PECOS EnrolledAccepts Medicare Assignment
462626 STATE ROAD 200 STE 300, YULEE, FL 32097(904) 398-7205 Get Directions Write a Review

NPPES record last updated: October 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 7, 2025, Apr 11, 2019 (2 updates tracked since 2019).

About Avery Camille Chisholm Md NPPES

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

AVERY CAMILLE CHISHOLM MD (NPI 1558824912) is an individual gastroenterology provider in Yulee, Florida, licensed in Florida (ME175195) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of Mercer University School Of Medicine (2019).

NPPES Registry Identity

NPI1558824912
Entity TypeIndividualFemale
Primary Taxonomy207RG0100X
Provider Legal NameAVERY CAMILLE CHISHOLMCredential: MD
Location Address462626 STATE ROAD 200 STE 300Yulee, FL 32097-5516
Mailing Address4800 Belfort RdJacksonville, FL 32256-6004 · (904) 504-8195
Sole ProprietorNo
Medical School CMSMercer University School Of MedicineGraduated 2019
Enumeration DateApril 11, 2019
Last NPPES UpdateOctober 7, 20252 updates tracked since enumeration
NPPES CertifiedOctober 7, 2025
NPI 1558824912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
License Licensed in FL · ME175195
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
462626 STATE ROAD 200 STE 300, Yulee, FL 32097

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Avery Camille Chisholm Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9931430048
PECOS Enrollment IDI20251107002851
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.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100088
Location800 Prudential DrJacksonville, FL 32207 · Duval County
Emergency services Birthing friendly

Baptist Medical Center - Nassau

Acute Care Hospitals · Fernandina Beach, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100140
Location1250 S 18th StFernandina Beach, FL 32034 · Nassau County
Emergency services

Southeast Georgia Health System -- Camden Campus

Acute Care Hospitals · Saint Marys, GA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number110146
Location2000 Dan Proctor DriveSaint Marys, GA 31558 · Camden County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32097 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

Clinic/Center (Ambulatory Surgical)
462626 STATE ROAD 200 STE 300
YULEE, FL 32097

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Avery Chisholm's NPI number?

The NPI number for Avery Chisholm is 1558824912. It was assigned to this individual provider in the NPPES registry on April 11, 2019.

Where is Avery Chisholm located?

Avery Chisholm practices at 462626 State Road 200 Ste 300, Yulee, FL 32097. The listed phone number is (904) 398-7205.

What is Avery Chisholm's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Is Avery Chisholm enrolled in Medicare?

Yes. Avery Chisholm is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Avery Chisholm accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Avery Chisholm as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Avery Chisholm affiliated with any hospitals?

According to CMS data, Avery Chisholm is affiliated with Baptist Health Medical Center - Jacksonville, Baptist Medical Center - Nassau and Southeast Georgia Health System -- Camden Campus.

When was this NPI record last updated?

The NPPES record for Avery Chisholm was last updated on October 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.