Jacque Chirico, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-061240 Issued in AL

Practice address

321 Veterans Memorial Drive
Suite 125
Troy, AL 36082-0001

Phone

(334) 670-3452

Fax

(334) 670-3853

NPI assigned

Jul 22, 2006

Sex

Female

Sole proprietor

Yes

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.

• Troy Unitersity Student Health Center

  • Health Service Clinic/Center
  • Troy, AL
  • NPI 1831532050
  NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in AL

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

Certified Registered Nurse

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 21, 2024.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1497776561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 VETERANS MEMORIAL DRIVE",
            "address_2": "SUITE 125",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360820001",
            "telephone_number": "334-670-3452",
            "fax_number": "334-670-3853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 VETERANS MEMORIAL DRIVE",
            "address_2": "SUITE 125",
            "city": "TROY",
            "state": "AL",
            "postal_code": "360820001",
            "telephone_number": "334-670-3452",
            "fax_number": "334-670-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIRICO",
        "first_name": "JACQUE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-061240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051557146",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE B RAILROAD",
            "identifier": "CG4892",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charity'S Grace LLC
• Charles a Wood, M.D., P.C
• Charles Henderson Memorial Association
• Phylecya Yvette Cheatham, M.D.
• Vickie Ivey Childs, CRNP
• Christina Zanakis-Tempelis
• City of Troy
• Kelli Kervin Cleveland, CRNP
• Jasmine Collette
• Kyle Adam Conatser, ORTHOPEDIC LMT

• All providers in Troy, AL
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.