Active NPI
Amber Ingram Chauncey, ARNP
- Pediatric Nurse Practitioner
- Live Oak, FL
National Provider Identifier
1043219645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- ARNP3319392
- Practice address
- 1002 11TH St SW
Live Oak, FL 32064-3606 - Phone
- (386) 364-8050
- NPI assigned
- Jul 18, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP3319392 | FL | |
| Pediatric Nurse Practitioner | 363LP0200X | ARNP3319392 | FL | Primary |
Addresses
Primary practice location
1002 11TH St SW
Live Oak, FL 32064-3606
Mailing address
10660 161St Rd
Live Oak, FL 32060-6280
Phone (386) 688-3865
Other practice location 1
1426 Canyon Ave NE
Live Oak, FL 32064
Phone (863) 208-0537
Other practice location 2
611 SE Demorest St
Live Oak, FL 32064
Phone (386) 362-5437
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21213600 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP3319392 | FL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Andres R Villar MD | Past | Accepting new patients | |
| Andres R Villar MD | Past | Accepting new patients | |
| Horizon Pediatrics, LLC | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Lake City, FL
- NPI 1356435457
-
- Pediatrics Physician
- Live Oak, FL
- NPI 1902571532
-
- Primary Care Clinic/Center
- Live Oak, FL
- NPI 1144475823
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654732800000",
"number": "1043219645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10660 161ST RD",
"city": "LIVE OAK",
"state": "FL",
"postal_code": "320606280",
"telephone_number": "386-688-3865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1002 11TH ST SW",
"city": "LIVE OAK",
"state": "FL",
"postal_code": "320643606",
"telephone_number": "386-364-8050"
}
],
"practiceLocations": [
{
"address_1": "1426 Canyon Ave NE",
"address_purpose": "LOCATION",
"city": "Live Oak",
"state": "FL",
"postal_code": "32064",
"country_code": "US",
"telephone_number": "863-208-0537",
"fax_number": "386-330-0180",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "611 SE Demorest St",
"address_purpose": "LOCATION",
"city": "Live Oak",
"state": "FL",
"postal_code": "32064",
"country_code": "US",
"telephone_number": "386-362-5437",
"fax_number": "386-362-5440",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHAUNCEY",
"first_name": "AMBER",
"middle_name": "INGRAM",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-18",
"last_updated": "2022-06-09",
"certification_date": "2022-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "ARNP3319392",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "ARNP3319392",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "21213600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Live Oak, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.