Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Chase Jackman, PA

Individual provider Physician Assistant · NPI 1396594339

Chase Jackman, PA is a Physician Assistant in Provo, Utah. Qualified in 2025, 1 year ago. Practices with Revere Health PC, a 410-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
1
Licensed in
UT
In the registry since
2024
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1055 N 500 W Ste 121 Bldg C
Provo, UT 84604-3305
Phone: (801) 373-7350
Fax: (801) 812-5401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 700 W 800 N Ste 100, Orem, UT 84057-6301 — (801) 373-7350

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 14246720-1206 (UT)

Record details

NPI number1396594339
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedMay 13, 2024
Last updated in NPPESOctober 10, 2025
Certification dateOctober 10, 2025
Mailing address1055 N 500 W, Provo, UT 84604-3305

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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