Individual provider Active NPI

Jessica Anne Chance, MSN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1306311410
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP139108 Issued in TX
Practice address
5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-7200
Phone
(214) 633-5555
NPI assigned
Oct 5, 2018
Last updated
Oct 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP139108 TX Primary
Critical Care Medicine Registered Nurse 163WC0200X 801567 TX

Addresses

Primary practice location

5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-7200

Mailing address

811 Brookhurst Dr
Richardson, TX 75080-5003
Phone (214) 529-2811

Other names 1

  • Jessica Anne Berrens Former name

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190102002898 TX Practitioner - Nurse Practitioner 6800131350 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
801567TXMDCritical Care Medicine Registered Nurse
AP139108TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 5, 2018 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 5, 2018 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1306311410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 BROOKHURST DR",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750805003",
            "telephone_number": "214-529-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD STOP 7200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907200",
            "telephone_number": "214-633-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANCE",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MSN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP139108",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "TX",
            "license": "801567",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BERRENS",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.