Jackson C Chen, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K5082 Issued in TX

Practice address

14725 Compass St
Corpus Christi, TX 78418-6030

Phone

(361) 949-6290

Fax

(361) 949-6268

NPI assigned

Nov 17, 2005

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

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.

• C H Wilkinson Physician Network

  dba CHRISTUS Physician Group

  • Family Medicine Physician
  • Irving, TX
  • NPI 1457382947
  Medicare reassignment NPD
• C H Wilkinson Physician Network

  dba CHRISTUS Physician Group

  • Orthopaedic Surgery Physician
  • Corpus Christi, TX
  • NPI 1750826095
  NPD

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063494797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 HIDDEN RDG",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750383813",
            "telephone_number": "469-282-2711",
            "fax_number": "469-282-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14725 COMPASS ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784186030",
            "telephone_number": "361-949-6290",
            "fax_number": "361-949-6268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JACKSON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K5082",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED PTAN",
            "identifier": "363090YLPS",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142694204",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosenda Chavez, APRN
• Kasi Viswanatha Raju Chekuri, MD
• Jack Chelebian, M.D.
• Anna Jasmine Chen, REGISTERED NURSE
• Defeng Chen, MD
• Richard P. Chepey, M.D.
• Rose Cherian, PHARMD, RPH
• Ryan Cherian, DO
• Cheryl L. Rhoden, DDS, PC
• CHI Medical Services PLLC

• Family Medicine Physician in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.