Individual provider Active NPI

Jessica Chonlahan

  • Physician Assistant
  • Aurora, CO
National Provider Identifier
1639474620
Registry record updated Jun 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0003905 Issued in CO
Practice address
1501 S. Potomac St.
Aurora, CO 80012-5411
Phone
(303) 695-2628
Fax
(303) 306-7753
NPI assigned
Jan 21, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1944 OK
Physician Assistant 363A00000X PA.0003905 CO Primary

Addresses

Primary practice location

1501 S. Potomac St.
Aurora, CO 80012-5411

Mailing address

P.O. Box 173862
Denver, CO 80217-3862
Phone (303) 306-7783

Other identifiers 1

IdentifierTypeStateIssuer
04872843MedicaidCO

Other names 1

  • Jessica Chinlahan Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20110525000328 OK Practitioner - Physician Assistant 9234315367 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1944OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ou Health Partners, Inc CurrentSince Aug 31, 2024 Accepting new patients

Locations

700 NE 13th St
Oklahoma City, OK 73104
Phone (405) 271-3667

900 NE 10th St
Oklahoma City, OK 73104
Phone (405) 271-2230

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": "1295568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1639474620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 173862",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173862",
            "telephone_number": "303-306-7783",
            "fax_number": "303-306-7753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S. POTOMAC ST.",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800125411",
            "telephone_number": "303-695-2628",
            "fax_number": "303-306-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONLAHAN",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-21",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "1944",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0003905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04872843",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "CHINLAHAN",
            "credential": "PA-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.