Individual provider Active NPI

Jennifer Chamness, NP

  • Family Nurse Practitioner
  • Douglas, AZ
National Provider Identifier
1225405202
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
TAP8075 Issued in AZ
Practice address
100 E 5TH St
Douglas, AZ 85607-2859
Phone
(520) 364-7659
NPI assigned
Aug 26, 2015
Last updated
Aug 26, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X TAP8075 AZ Primary

Addresses

Primary practice location

100 E 5TH St
Douglas, AZ 85607-2859

Mailing address

6445 E Desperado Dr
Hereford, AZ 85615-8930
Phone (815) 757-3939

Other names 1

  • Jennifer Chamness Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20160111002333 AZ Practitioner - Nurse Practitioner 3274843602 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bisbee Hospital AssociationGroup PAC ID 5092626168, 69 clinicians

Practice addresses (Care Compare)

100 E 5TH St
Douglas, AZ 85607-2859
Phone (520) 364-7659

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TAP8075AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bisbee Hospital Association CurrentSince Dec 1, 2015 Accepting new patients
Bisbee Hospital Association CurrentSince Dec 1, 2015 Accepting new patients

Locations

101 Cole Ave
Bisbee, AZ 85603
Phone (520) 432-5383

100 E 5th St
Douglas, AZ 85607
Phone (520) 364-7659

Interoperability endpoints

  • Direct secure messaging: jenniferchamness@cqch.cernerdirect.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1225405202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6445 E DESPERADO DR",
            "city": "HEREFORD",
            "state": "AZ",
            "postal_code": "856158930",
            "telephone_number": "815-757-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E 5TH ST",
            "city": "DOUGLAS",
            "state": "AZ",
            "postal_code": "856072859",
            "telephone_number": "520-364-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMNESS",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "TAP8075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "CHAMNESS",
            "credential": "N.P.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Douglas, AZ

Sources for this page

Verify at the official NPI Registry.