Jiyoung Chae, | |
253 Sagamore Pkwy W, West Lafayette, IN 47906-1501 | |
(765) 448-8000 | |
Not Available |
Full Name | Jiyoung Chae |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 9 Years |
Location | 253 Sagamore Pkwy W, West Lafayette, Indiana |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1568845295 | NPI | - | NPPES |
000000964485 | Other | IN | ANTHEM PROVIDER PIN NUMBER |
201323610 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 28193970A (Indiana) | Secondary |
363LP2300X | Nurse Practitioner - Primary Care | 71005808A (Indiana) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Blount Memorial Hospital | Maryville, TN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Senior Care Partners Of East Tennessee Pllc | 4486801982 | 28 |
Volunteer Healthcare Services, Inc. | 8820003981 | 34 |
Entity Name | Senior Care Partners Of East Tennessee Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750639241 PECOS PAC ID: 4486801982 Enrollment ID: O20120905000362 |
Mailing Address | Practice Location Address |
---|---|
Jiyoung Chae, Po Box 5777, Maryville, TN 37802-5777 Ph: (865) 246-2104 | Jiyoung Chae, 253 Sagamore Pkwy W, West Lafayette, IN 47906-1501 Ph: (765) 448-8000 |
Laura L Wavra, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 124 Sagamore Pkwy W, West Lafayette, IN 47906 Phone: 765-463-6722 Fax: 765-463-0905 | |
Marcia Ann Stroup, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 253 Sagamore Pkwy W, West Lafayette, IN 47906 Phone: 765-448-8000 Fax: 765-448-8227 | |
Mrs. Ashley Nicole Hogan, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 502 N University St, West Lafayette, IN 47907 Phone: 317-207-7413 | |
Gayle Doll, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 512 Sagamore Pkwy W, West Lafayette, IN 47906 Phone: 765-497-3551 | |
Mrs. Stephanie L. Davitto, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 124 Sagamore Pkwy West, West Lafayette, IN 47906 Phone: 765-463-6722 Fax: 765-463-0905 | |
Yun Cai, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 601 Stadium Mall Dr, West Lafayette, IN 47907 Phone: 765-494-1700 | |
Azza H Ahmed, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 502 N University St, West Lafayette, IN 47907 Phone: 765-494-4040 |