Individual provider Active NPI

Jennifer Lee Chargois

  • Family Nurse Practitioner
  • League City, TX
National Provider Identifier
1487424768
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1151297 Issued in TX
Practice address
2785 Gulf Fwy S Ste 2.200
League City, TX 77573-4979
Phone
(409) 772-3695
NPI assigned
Jan 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1151297 TX Primary

Addresses

Primary practice location

2785 Gulf Fwy S Ste 2.200
League City, TX 77573-4979

Mailing address

303 University Blvd
Galveston, TX 77555-0001

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
I20240304003583 TX Practitioner - Nurse Practitioner 9133564818 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1151297TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Mar 15, 2024 Accepting new patients
University of Texas Medical Branch at Galveston PastSince Jan 14, 2024 Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

2785 Gulf Fwy S
Ste 2200
League City, TX 77573
Phone (409) 772-3695

Interoperability endpoints

  • Direct secure messaging: jchargois28629@direct.utmb.edu

Organizations & group practices 2

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": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1487424768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 UNIVERSITY BLVD",
            "city": "GALVESTON",
            "state": "TX",
            "postal_code": "775550001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2785 GULF FWY S STE 2.200",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775734979",
            "telephone_number": "409-772-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARGOIS",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1151297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

Verify at the official NPI Registry.