Active NPI
Alan Jennings Chen, M.D.
- Family Medicine Physician
- Dexter, MO
National Provider Identifier
1760479141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- R1K96
- Practice address
- 1516 W Business Hwy 60
Dexter, MO 63841 - Phone
- (573) 624-8051
- Fax
- (573) 624-6669
- NPI assigned
- Sep 30, 2005
- Last updated
- Dec 14, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | R1K96 | MO | Primary |
Addresses
Primary practice location
1516 W Business Hwy 60
Dexter, MO 63841
Mailing address
PO Box 39
Dexter, MO 63841-0039
Phone (573) 624-8051
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202742003 | Medicaid | MO | |
| R1K96 | Other | MO | STATE LICENCE |
| 4784 | Other | MO | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292284800000",
"number": "1760479141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 39",
"city": "DEXTER",
"state": "MO",
"postal_code": "638410039",
"telephone_number": "573-624-8051",
"fax_number": "573-624-6669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1516 W BUSINESS HWY 60",
"city": "DEXTER",
"state": "MO",
"postal_code": "63841",
"telephone_number": "573-624-8051",
"fax_number": "573-624-6669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "ALAN",
"middle_name": "JENNINGS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-30",
"last_updated": "2010-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "R1K96",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202742003",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENCE",
"identifier": "R1K96",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "4784",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dexter, MO
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- Pamela Jean Chamberlain, RN
- Chiropractic Associates of Semo, LLC
- Kayla Michelle Clark
- Clearwater in-Home Care, Inc.
- Vincent Harlon Coburn, O.D.
- Krista Lynn Conde, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.