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1306836093

NPI Code Detail

MEDICARE: DR. JENNIFER LYNN MCCAULEY MD

MEDICARE: DR. JENNIFER LYNN MCCAULEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	2018-01071	NC
2	207R00000X	Internal Medicine Physician	207692	MA
3	208000000X	Pediatrics Physician	207692	MA
4	207R00000X	Internal Medicine Physician	2018-01071	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	207692	OTHER	MA	TUFTS HEALTH PLAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	J24735	OTHER	MA	BCBS MA

General Provider Information

NPI Number	:	1306836093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER LYNN MCCAULEY MD

Provider Business Mailing Address
First Line	:	2000 PERIMETER PARK DR STE 200
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-8442
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	118 KNOX WAY
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-6610
Country	:	US
Telephone Number	:	984-215-5900
Fax Number	:	984-215-5942

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	05/11/2021

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Directions to “ DR. JENNIFER LYNN MCCAULEY MD” Practice Location

Language	Start Address	Practice Location

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