Individual provider Active NPI

Shen En Chen, M.D., M.P.H., PH.D.

  • Internal Medicine Physician
  • Jackson, MS
National Provider Identifier
1891236196
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
27962 Issued in MS
Practice address
2500 N. State Street
Department of Neurology
Jackson, MS 39216
Phone
(601) 984-5514
Fax
(601) 984-5503
NPI assigned
Mar 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 27962 MS
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 27962 MS Primary

Addresses

Primary practice location

2500 N. State Street
Department of Neurology
Jackson, MS 39216

Mailing address

2500 N. State Street
Department of Neurology
Jackson, MS 39216
Phone (601) 984-5514

Other practice location 1

1415 Tulane Ave
New Orleans, LA 70112-2600
Phone (504) 988-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20230214000108 MS Practitioner - Internal Medicine 7113270703 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC General Practice CurrentSince Dec 22, 2022 Accepting new patients

Locations

460 Briarwood Dr
Ste 400
Jackson, MS 39206
Phone (601) 203-1016

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1891236196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 N. STATE STREET",
            "address_2": "DEPARTMENT OF NEUROLOGY",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-984-5514",
            "fax_number": "601-984-5503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N. STATE STREET",
            "address_2": "DEPARTMENT OF NEUROLOGY",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39216",
            "telephone_number": "601-984-5514",
            "fax_number": "601-984-5503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Tulane Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122600",
            "country_code": "US",
            "telephone_number": "504-988-5800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "SHEN EN",
        "name_prefix": "Dr.",
        "credential": "M.D., M.P.H., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MS",
            "license": "27962",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "27962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.