Active NPI
Jian-Jun Chen, MD, PHD
- Gastroenterology Physician
- Titusville, FL
National Provider Identifier
1861505463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- ME93471
- Practice address
- 407 S Washington Ave
Suite 1
Titusville, FL 32796-3500 - Phone
- (321) 385-0884
- Fax
- (321) 385-9578
- NPI assigned
- Aug 16, 2006
- Last updated
- Feb 6, 2014
- 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 |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ME93471 | FL | Primary |
Addresses
Primary practice location
407 S Washington Ave
Suite 1
Titusville, FL 32796-3500
Mailing address
407 S Washington Ave Ste 1
Titusville, FL 32796-3500
Phone (321) 385-0884
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 276444000 | Medicaid | FL | |
| 28795 | Other | FL | BLUE CROSS BLUE SHIELD |
| ME93471 | Other | FL | MEDICAL LIC |
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, Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Professional Services of Brevard LLC | Past | Accepting new patients |
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.
-
- Certified Registered Nurse Anesthetist
- Rockledge, FL
- NPI 1164657995
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391644800000",
"number": "1861505463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 S WASHINGTON AVE STE 1",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327963500",
"telephone_number": "321-385-0884",
"fax_number": "321-385-9578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 S WASHINGTON AVE",
"address_2": "SUITE 1",
"city": "TITUSVILLE",
"state": "FL",
"postal_code": "327963500",
"telephone_number": "321-385-0884",
"fax_number": "321-385-9578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHEN",
"first_name": "JIAN-JUN",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2014-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME93471",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "276444000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "28795",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LIC",
"identifier": "ME93471",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Titusville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.