Chancelor McColley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9115014 Issued in FL

Practice address

8430 Enterprise Cir Ste 130
Lakewood Ranch, FL 34202-4111

Phone

(941) 366-3000

Fax

(941) 366-3002

NPI assigned

Nov 10, 2021

Last updated

Nov 10, 2021By 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

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chancelor.mccolley@fpg.directbygreenway.com

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.

• SMH Physician Services Inc

  dba First Physicians Group

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1346295292

  Physician Assistant

  Medicare reassignment NPD
• SMH Physician Services Inc

  dba First Physicians Group

  • Gynecology Physician
  • Sarasota, FL
  • NPI 1275525826
  NPD (past)

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636502400000",
    "number": "1326704826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 947407",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303947407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 ENTERPRISE CIR STE 130",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342024111",
            "telephone_number": "941-366-3000",
            "fax_number": "941-366-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLEY",
        "first_name": "CHANCELOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Matunas, PA-C
• Bryant Maxwell
• Olena May, MS, LDN, CNS
• Ruth McAllister, APRN, PMHNP-BC
• Amanda Leigh McCaw, PSY.D.
• Katie McColley, PTA
• Reese Melina McCorry
• Jennifer R McCullen, MD
• Drew McCullough
• Carlissa Jahnae McFarland

• Physician Assistant in Lakewood Ranch, FL
• Providers in Lakewood Ranch, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.