Charlene Chan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

306403 Issued in LA

Practice address

4960 Saint Claude Ave
New Orleans, LA 70117-4258

Phone

(504) 533-4999

NPI assigned

Apr 12, 2016

Last updated

Apr 13, 2020By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Thomas Community Health Center IncGroup PAC ID 8527163211, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St. Thomas Community Health Center, Inc.

  dba St. Thomas Community Health Center Erwin Bldg

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
  • NPI 1003185125
  Medicare reassignment Care Compare group NPD
• St. Thomas Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
  • NPI 1295757326
  NPD
• St. Thomas Community Health Center, Inc

  dba St. Thomas Pharmacy Columbia Parc

  • Community/Retail Pharmacy
  • New Orleans, LA
  • NPI 1417786062
  NPD
• St. Thomas Community Health Center, Inc

  dba St. Thomas Community Health Center

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
  • NPI 1699115600
  NPD (past)
• St. Thomas Community Health Center, Inc.

  dba St Thomas at Holiday Drive

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
  • NPI 1659082105
  NPD (past)
• St. Thomas Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • New Orleans, LA
  • NPI 1730828419
  NPD (past)

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1801250220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 HOUMA BLVD",
            "address_2": "STE 200",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700063000",
            "telephone_number": "504-454-7878",
            "fax_number": "504-883-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4960 SAINT CLAUDE AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701174258",
            "telephone_number": "504-533-4999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4228 Houma Blvd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Metairie",
            "state": "LA",
            "postal_code": "700063000",
            "country_code": "US",
            "telephone_number": "504-454-7878",
            "fax_number": "504-883-3775",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "CHARLENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "306403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Champion Medical Center
• Champion Medical Center
• Joneae Champion
• Tyler Champion
• Ashley Chan, PA-C
• Jessica Skold Clark Chandamuri, M.D.
• Beren Chandler
• Ermine Faye Chandler, C.R.N.A.
• Grace Chandler
• Jonathan Nicholas Chandler, PSYD, MP

• Family Medicine Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.