Chantel Baucum

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

1905 Sunnyside Ave
Hopewell, VA 23860-7124

Phone

(434) 250-4591

NPI assigned

Oct 13, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Birth Through Life Interventions Supports & Services LLC

  • Early Intervention Provider Agency
  • Hopewell, VA
  • NPI 1306563523
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1053037945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 SUNNYSIDE AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238607124",
            "telephone_number": "434-250-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 SUNNYSIDE AVE",
            "city": "HOPEWELL",
            "state": "VA",
            "postal_code": "238607124",
            "telephone_number": "434-250-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUCUM",
        "first_name": "CHANTEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "920759686",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "birththroughlifeservices@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "address_1": "1905 Sunnyside Ave",
            "city": "Hopewell",
            "state": "VA",
            "country_code": "US",
            "postal_code": "238607124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Back Home Pharmacy Inc
• Kristen Bagley, FNP-C
• Daniel Morgan Baker, DDS
• Darwyn Annette Barnes, CEO
• Nasr Basir Balla, NURSE PRACTITIONER
• Nicole Kathleen Beer, NP
• Evelyn Benedict
• Benevolent Hearts Homecare LLC
• Pedro Berrios
• Mohammad Bhuiyan

• Developmental Therapist in Hopewell, VA
• Providers in Hopewell, VA by specialty
• Developmental Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.

Verify at the official NPI Registry.