Individual provider Active NPI

Jacque Chirico, CRNP

  • Nurse Practitioner
  • Troy, AL
National Provider Identifier
1497776561
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
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
Last updated
Aug 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-061240 AL Primary

Addresses

Primary practice location

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

Mailing address

321 Veterans Memorial Drive
Suite 125
Troy, AL 36082-0001
Phone (334) 670-3452

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20060111001049 AL Practitioner - Nurse Practitioner 3577586957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-061240ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Troy Unitersity Student Health Center CurrentSince Aug 25, 2024 Accepting new patients

Locations

321 Veterans Memorial Dr
Troy, AL 36082
Phone (334) 670-3452

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, AL

Sources for this page

Verify at the official NPI Registry.