JENELLE VIRGINIA CHU
Complete NPI Record 1558096313
Physician Assistant - Surgical in Frederick, MD
Active since July 17, 2022PECOS EnrolledAccepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Jenelle Virginia Chu (NPI 1558096313), an individual physician assistant provider in Frederick, MD. All 31 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1558096313 Field 1/31
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/31
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: CHU Field 3/31
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: JENELLE Field 4/31
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: VIRGINIA Field 5/31
- The middle name of the provider, if the provider is an individual.
- Provider First Line Business Mailing Address: 9600 PARK AVE Field 6/31
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: LAUREL Field 7/31
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: MD Field 8/31
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 207231851 Field 9/31
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 10/31
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 3019790824 Field 11/31
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 7211 BANK CT Field 12/31
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: FREDERICK Field 13/31
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: MD Field 14/31
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 217038483 Field 15/31
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 16/31
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 2402156310 Field 17/31
- The telephone number associated with the location address of the provider being identified.
- Provider Gender Code: F Field 20/31
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 363AS0400X Field 21/31
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 5857 Field 22/31
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: CT Field 23/31
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 24/31
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 363AS0400X Field 25/31
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: C09140 Field 26/31
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: MD Field 27/31
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: Y Field 28/31
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Sole Proprietor: Y Field 29/31
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
- Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP Field 30/31
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 14
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
1 Frederick Health Way
Location 1/14Frederick, MD 21701-9435 · Phone (240) 215-6310
194 Thomas Johnson Dr
Location 2/14Frederick, MD 21702-4679 · Phone (240) 215-6310
501 W 7th St
Location 3/14Frederick, MD 21701-4586 · Phone (240) 215-6310
400 W 7th St
Location 4/14Frederick, MD 21701-4506 · Phone (240) 215-6310
15 E Frederick St
Location 5/14Walkersville, MD 21793-8234 · Phone (240) 215-6310
3000D Ventrie Ct
Location 6/14Myersville, MD 21773-7817 · Phone (240) 215-6310
3430 Worthington Blvd
Location 7/14Frederick, MD 21704-7017 · Phone (240) 215-6310
1562 Opossumtown Pike
Location 8/14Frederick, MD 21702-4920 · Phone (240) 215-6310
504 E Ridgeville Blvd
Location 9/14Mount Airy, MD 21771-5942 · Phone (240) 215-6310
34 Maple St
Location 10/14Norwalk, CT 06850-3815 · Phone (203) 852-2000
1194 Dutchmans Creek Dr
Location 11/14Brunswick, MD 21716-9786 · Phone (240) 215-6310
141 Thomas Johnson Dr
Location 12/14Frederick, MD 21702-4502 · Phone (301) 846-0100
75 Thomas Johnson Dr
Location 13/14Frederick, MD 21702-4895 · Phone (240) 215-6310
16403 Old Emmitsburg Rd
Location 14/14Emmitsburg, MD 21727-8929 · Phone (240) 215-6310
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