Active NPI
Dara Lauran Chance
- Psychiatric/Mental Health Nurse Practitioner
- Jacksonville, NC
National Provider Identifier
1124836077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- PMH12240034
- Practice address
- 4006 Henderson Dr
Jacksonville, NC 28546-0055 - Phone
- (910) 353-6406
- NPI assigned
- Dec 24, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | PMH12240034 | NC | Primary |
Addresses
Primary practice location
4006 Henderson Dr
Jacksonville, NC 28546-0055
Mailing address
381 Frisco Way
Holly Ridge, NC 28445-4203
Phone (910) 265-0049
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 |
|---|---|---|---|
| PMH12240034 | NC | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735257600000",
"number": "1124836077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "381 FRISCO WAY",
"city": "HOLLY RIDGE",
"state": "NC",
"postal_code": "284454203",
"telephone_number": "910-265-0049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4006 HENDERSON DR",
"city": "JACKSONVILLE",
"state": "NC",
"postal_code": "285460055",
"telephone_number": "910-353-6406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANCE",
"first_name": "DARA",
"middle_name": "LAURAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-12-24",
"last_updated": "2024-12-27",
"certification_date": "2024-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NC",
"license": "PMH12240034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.