● Active Type 1 · Individual

Jacqueline Chan, M.D.

Pediatrics·Augusta, GA· NPI 1356735914 · Enumerated 2015 · 11 years on NPI

Chan is 1 of 4 pediatrics providers in Augusta and 1 of 47 in Georgia.

NPI age

11 years

Enumerated 2015-03-22

Primary specialty

Pediatrics

Plus 1 subspecialty

Licensed in

1 state

Status

Active

No deactivations on record

Last NPPES update

2023-06-14

Source: monthly bulk 2026-05

Sole proprietor

Yes

Solo practice on file

How this provider compares

Across 47 active pediatrics providers in Georgia.

NPI age

11 years

↓ 6 yr below median (17 yr)

State licenses

1 state

8% of peers hold multiple states

Subspecialties

In the 25% of peers with subspecialties

NPI lifetime · 2015 → 2026

2015-03Enumerated in NPPES

2015 2026

Where they practice

Practice location

1120 15th St

Augusta, GA 309127232

📞 7067218623

Mailing address

1499 Walton Way, Ste 1400

Augusta, GA 309012603

Additional practice locations

1 secondary location on file with NPPES.

Location 2

1740 W Taylor St

Chicago, IL 606127232

📞 8666002273

Specialties

Allopathic & Osteopathic Physicians › Pediatrics

Pediatrics Primary

A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth...

GA license #079530 taxonomy 2080P0205X
Student in an Organized Health Care Education/Training Program

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

taxonomy 390200000X

Practice context

Part of a multi-provider practice. 1593 other active providers share this practice address in NPPES.

Provyx · Custom healthcare lists

Need all 47 Pediatrics providers in Georgia?

Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.

Request a quote →

How to verify this provider

Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
Check the state license is currently active.State licensing boards publish current status; NPPES does not.
Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.