Individual provider Active NPI

Daniela A Kantcheva, RN,MSN,APRN,BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1124072350
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
140910 Issued in MO
Practice address
402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone
(573) 334-1100
NPI assigned
May 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 140910 MO Primary

Addresses

Primary practice location

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536

Mailing address

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone (573) 334-1100

Other identifiers 4

IdentifierTypeStateIssuer
429463706MedicaidMO
431823864OtherCORPHELATH
724467OtherHEALTHLINK/FREEDOM
7224467OtherHEALTHLINK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060109000019 MO Practitioner - Nurse Practitioner 7416970249 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Counseling CenterGroup PAC ID 9436142460, 22 clinicians

Practice addresses (Care Compare)

402 S Silver Springs Rd
Cape Girardeau, MO 63703-7536
Phone 57333411002780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community Counseling Center CurrentSince Dec 5, 2007 Accepting new patients
New Vision Youth and Family Services Inc PastSince Oct 9, 2022 Accepting new patients

Locations

402 S Silver Springs Rd
Cpe Girardeau, MO 63703
Phone (573) 334-1100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1124072350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 S SILVER SPRINGS RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037536",
            "telephone_number": "573-334-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S SILVER SPRINGS RD",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637037536",
            "telephone_number": "573-334-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTCHEVA",
        "first_name": "DANIELA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "RN,MSN,APRN,BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "140910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429463706",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPHELATH",
            "identifier": "431823864",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK/FREEDOM",
            "identifier": "724467",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "7224467",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.