Healthcare Provider Details

I. General information

NPI: 1285209064
Provider Name (Legal Business Name): JESSE CHAMPI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 RALEIGH RD
CHAPEL HILL NC
27517-4412
US

IV. Provider business mailing address

101 MANNING DR
CHAPEL HILL NC
27514-4220
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-7890
  • Fax: 919-966-9533
Mailing address:
  • Phone: 984-974-0298
  • Fax: 984-974-0755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2026-04167
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: