Jacqueline Yvonne Chacon, ANP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1370 Issued in HI

Practice address

91-896 Makule Rd
Suite 102
Ewa Beach, HI 96706-2543

Phone

(808) 689-4414

Fax

(808) 689-7115

NPI assigned

May 1, 2012

Last updated

Oct 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqueline.chacon.p1@direct.wcchc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Wahiawa Center for Community Health

  dba 'Wahiawa Health'

  • Federally Qualified Health Center (FQHC)
  • Wahiawa, HI
  • NPI 1992176283
  Medicare reassignment NPD
• Venture Medical 21 Inc

  • Clinic/Center
  • Ewa Beach, HI
  • NPI 1851647952
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1023376779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91-896 MAKULE RD",
            "address_2": "SUITE 102",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967062543",
            "telephone_number": "808-689-4414",
            "fax_number": "808-689-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91-896 MAKULE RD",
            "address_2": "SUITE 102",
            "city": "EWA BEACH",
            "state": "HI",
            "postal_code": "967062543",
            "telephone_number": "808-689-4414",
            "fax_number": "808-689-7115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACON",
        "first_name": "JACQUELINE",
        "middle_name": "YVONNE",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-01",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "HI",
            "license": "1370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Christine Cavanagh, PSY.D.
• Thea Ann Cayaban de Vero, PT/PTA
• Center for Allergy and Respiratory Diseases Inc. (Card Inc.)
• Vanessa Dulay Cerezo
• David Sung Geun Cha, MD
• Melissa Chamlee
• CHI Nga Chan, MD
• Daniel K Chan, MD
• Fuchat Chan, M.D.
• Kelly K Chan

• Family Nurse Practitioner in Ewa Beach, HI
• Providers in Ewa Beach, HI by specialty
• Family Nurse Practitioner in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.