Active NPI
Jennifer Nicole Chan, PA-C
- Physician Assistant
- Austin, TX
National Provider Identifier
1245364231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA04003
- Practice address
- 631 W 38TH St
Austin, TX 78705-1250 - Phone
- (512) 451-5161
- NPI assigned
- Mar 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA04003 | TX | Primary |
Addresses
Primary practice location
631 W 38TH St
Austin, TX 78705-1250
Mailing address
801 Oak Park Dr
Round Rock, TX 78681-4077
Phone (512) 851-3390
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA04003 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| OBGYN Partners of Augusta, Professional Corporation | Past | Accepting new patients |
Interoperability endpoints
- jennifer.chan.1@21024.direct.athenahealth.com
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.
-
- Obstetrics & Gynecology Physician
- Augusta, GA
- NPI 1801825104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773619200000",
"number": "1245364231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 OAK PARK DR",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786814077",
"telephone_number": "512-851-3390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "631 W 38TH ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051250",
"telephone_number": "512-451-5161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "JENNIFER",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2026-03-16",
"certification_date": "2026-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA04003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.