Individual provider Active NPI

Jennifer Ann Chancellor, MD

  • Obstetrics & Gynecology Physician
  • Raleigh, NC
National Provider Identifier
1467673186
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2008-00615 Issued in NC
Practice address
4414 Lake Boone Trail
Suite 300
Raleigh, NC 27607
Phone
(919) 781-5510
Fax
(919) 781-5053
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2008-00615 NC
Obstetrics & Gynecology Physician 207V00000X 2008-00615 NC Primary

Addresses

Primary practice location

4414 Lake Boone Trail
Suite 300
Raleigh, NC 27607

Mailing address

2615 Lake Dr Ste 201
Raleigh, NC 27607-6694
Phone (919) 232-6880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080807000191 NC Practitioner - Obstetrics/Gynecology 7517031651 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2008-00615NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Whap, PA Obstetrics & Gynecology Past Accepting new patients
Wakemed Faculty Practice Plan Obstetrics & Gynecology Past Accepting new patients
Wakemed Faculty Practice Plan Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jennifer.chancellor.1@7773.direct.athenahealth.com

Organizations & group practices 4

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": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1467673186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 LAKE DR STE 201",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076694",
            "telephone_number": "919-232-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4414 LAKE BOONE TRAIL",
            "address_2": "SUITE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27607",
            "telephone_number": "919-781-5510",
            "fax_number": "919-781-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANCELLOR",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "2008-00615",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2008-00615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.