Individual provider Active NPI

Gerad Chancellor

  • Community Health Worker
  • Glenn Heights, TX
National Provider Identifier
1003787565
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
1205 Seneca PL
Glenn Heights, TX 75154-8821
Phone
(469) 337-3711
NPI assigned
Sep 16, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PACE Provider Organization 251T00000X TX
Physical Disabilities Residential Treatment Facility 320700000X TX
Community Health Worker 172V00000X TX Primary

Addresses

Primary practice location

1205 Seneca PL
Glenn Heights, TX 75154-8821

Mailing address

1205 Seneca PL
Glenn Heights, TX 75154-8821
Phone (469) 337-3711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fuller Care LLC Community Health Worker CurrentSince Sep 28, 2025 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": "1757980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1003787565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 SENECA PL",
            "city": "GLENN HEIGHTS",
            "state": "TX",
            "postal_code": "751548821",
            "telephone_number": "469-337-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 SENECA PL",
            "city": "GLENN HEIGHTS",
            "state": "TX",
            "postal_code": "751548821",
            "telephone_number": "469-337-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANCELLOR",
        "first_name": "GERAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-16",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenn Heights, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.