Individual provider Active NPI

Jeremy Chandler, PA-C

  • Medical Physician Assistant
  • Lexington, KY
National Provider Identifier
1386199891
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA2123 Issued in KY
Practice address
1350 Bull Lea Rd
Lexington, KY 40511-1247
Phone
(859) 246-8158
NPI assigned
Aug 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2123 KY
Surgical Physician Assistant 363AS0400X PA2123 KY
Medical Physician Assistant 363AM0700X PA2123 KY Primary

Addresses

Primary practice location

1350 Bull Lea Rd
Lexington, KY 40511-1247

Mailing address

1350 Bull Lea Rd
Lexington, KY 40511-1247

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20170120002139 KY Practitioner - Physician Assistant 3476835752 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA2123KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth of Kentucky CurrentSince Nov 16, 2016 Accepting new patients
University of Kentucky CurrentSince Feb 1, 2021 Accepting new patients

Locations

1350 Bull Lea Rd
Lexington, KY 40511
Phone (859) 246-7363

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

Interoperability endpoints

  • Direct secure messaging: jchandler33670@ukhcdirect.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1386199891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 BULL LEA RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BULL LEA RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111247",
            "telephone_number": "859-246-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "JEREMY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-25",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2123",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA2123",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA2123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.