Jennifer Childers, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2208 Issued in TN

Practice address

511 Market Blvd Ste 103
Collierville, TN 38017-2360

Phone

(901) 850-1150

Fax

(901) 850-1102

NPI assigned

Oct 9, 2012

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 TN

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

Merit-based Incentive Payment System (MIPS)

Final score

79.93 of 100Reported as group

Quality

78.08

Promoting interoperability

74

Improvement activities

40

Cost

76.67

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: jennifer.childers.1@18248.direct.athenahealth.com

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.

• Delta Orthopaedics & Sports Medicine, PLLC

  • Orthopaedic Surgery Physician
  • West Memphis, AR
  • NPI 1043565773

  TN

  Medicare reassignment

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1033461447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1139 MACON RIDGE DR",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380176168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 MARKET BLVD STE 103",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380172360",
            "telephone_number": "901-850-1150",
            "fax_number": "901-850-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-09",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "2208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Danielle Chalmers, BCBA
• Marolyn M Chambers, APN
• Change Lives Through Education LLC
• Charles E. Young, Jr, DDS
• Sonya Walker Chehardy, D.O.
• Children'S Dental Center of West Tennessee
• Christian Family Solutions of the Mid-South
• Churchwell Pediatric Dentistry
• Caroline H Churchwell, DDS
• Molly M Churchwell, DDS

• Physician Assistant in Collierville, TN
• Providers in Collierville, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.