Jacqueline M Champlain, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R1713 Issued in TX

Practice address

1392 W US Highway 290
Unit 2
Elgin, TX 78621

Phone

(512) 285-3315

Fax

(512) 281-2872

NPI assigned

Jun 9, 2011

Last updated

Dec 26, 2023By the provider in NPPES

Sex

Female

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 TX

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

Specialty

Family Practice

Education

Loyola University of Chicago, Stritch School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellmed Medical Group PAGroup PAC ID 4880657386, 666 clinicians

Capital Area Primary Care, PLLCGroup PAC ID 9537237482, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3648/brand/1/csg/1/fhir/r4

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.

• Capital Area Primary Care, PLLC

  • Family Medicine Physician
  • Austin, TX
  • NPI 1023287976
  Medicare reassignment Care Compare group NPD
• Wellmed Medical Group, PA

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1437156486

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Wellmed Medical Group, P.a.

  dba WellMed Doctor's Hospital Senior Clinic

  • Family Medicine Physician
  • Corpus Christi, TX
  • NPI 1740588243
  NPD
• Fastrac Medical, P.C.

  • Emergency Medicine Physician
  • Joliet, IL
  • NPI 1659517597
  NPD (past)

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

{
    "created_epoch": "1307577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1497049209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1392 W US HIGHWAY 290",
            "address_2": "UNIT 2",
            "city": "ELGIN",
            "state": "TX",
            "postal_code": "78621",
            "telephone_number": "512-285-3315",
            "fax_number": "512-281-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1392 W US HIGHWAY 290",
            "address_2": "UNIT 2",
            "city": "ELGIN",
            "state": "TX",
            "postal_code": "78621",
            "telephone_number": "512-285-3315",
            "fax_number": "512-281-2872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPLAIN",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-09",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R1713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Bontrager, OD
• BTRL, LTD (Burning Tree Lodge)
• Kimberly Cadena, COTA
• Allica Cardona
• Kathrin Carter
• Chih Andrew Chen, OD
• Kimberley Roberts Christensen, RPH
• Sheridan Clemons
• Rikeisha Kennette Clinton, LVN
• Community Action, Inc. of Hays, Caldwell, and Blanco Counties

• Family Medicine Physician in Elgin, TX
• Providers in Elgin, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.