Anniqua Chandler

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-24-354059 Issued in FL

Practice address

13121 Atlantic Blvd Ste 200
Jacksonville, FL 32225-0102

Phone

(904) 491-2111

Fax

(904) 512-0613

NPI assigned

Jun 19, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Proactive Life Skills LLC

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1902331382
  NPD (past)

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1124862834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13121 ATLANTIC BLVD STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322250102",
            "telephone_number": "904-491-2111",
            "fax_number": "904-512-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13121 ATLANTIC BLVD STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322250102",
            "telephone_number": "904-491-2111",
            "fax_number": "904-512-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "ANNIQUA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-19",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-24-354059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara E Chance, PA-C
• Brittany Elizabeth Chancey
• Brooke Nichelle Chancey, PT, DPT, MS
• Chandelier Status Healthcare Services LLC
• Chandler Support Services, Inc.
• Dianne Chandler, PHARM D
• Isaisha Chandler
• Jerry Wayne Chandler II, D.O.
• Kelli Chandler, OTR/L
• Lindsay Mae Chandler, DPM

• Behavior Technician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.

Verify at the official NPI Registry.