Individual provider Active NPI

Brenda Chandler

  • Contractor
  • Shawnee, KS
National Provider Identifier
1104951243
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
6409 Charlotte St
Shawnee, KS 66216-2130
Phone
(913) 322-1764
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X KS Primary

Addresses

Primary practice location

6409 Charlotte St
Shawnee, KS 66216-2130

Mailing address

6409 Charlotte St
Shawnee, KS 66216-2130
Phone (913) 322-1764

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

LicenseStateTypeSpecialty
200329650AKSMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1104951243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6409 CHARLOTTE ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662162130",
            "telephone_number": "913-322-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6409 CHARLOTTE ST",
            "city": "SHAWNEE",
            "state": "KS",
            "postal_code": "662162130",
            "telephone_number": "913-322-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "BRENDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.