Todd Chancellor

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12699 Issued in FL

Practice address

808 S Broadway
Lantana, FL 33462-4400

Phone

(561) 797-7203

Fax

(561) 797-3014

NPI assigned

Sep 17, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• A Gentle Hand Residential Care

  • Assisted Living Facility
  • Lantana, FL
  • NPI 1154944775
  NPD Authorized official

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

{
    "created_epoch": "1537142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1134603129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13052 COMPTON RD",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334704714",
            "telephone_number": "561-797-7203",
            "fax_number": "561-795-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 S BROADWAY",
            "city": "LANTANA",
            "state": "FL",
            "postal_code": "334624400",
            "telephone_number": "561-797-7203",
            "fax_number": "561-797-3014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12450 Guilford Way",
            "address_purpose": "LOCATION",
            "city": "Village Of Wellington",
            "state": "FL",
            "postal_code": "334144969",
            "country_code": "US",
            "telephone_number": "561-797-7203",
            "fax_number": "561-795-3014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANCELLOR",
        "first_name": "TODD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-17",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105771000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nazira Cejas, BCBA
• Centerwell Pharmacy, Inc.
• Central Palm Beach Physicians & Urgent Care, Inc.
• Chah Acutherapy, LLC
• Maria Chah, L.M.T., L.AC.
• Charles R Wright DDS, PA
• Katrina L Chase
• Cherry Oak Palm Beach County, LLC
• Clickaclinic Com Inc
• Philip Andrew Cline, MSW

• All providers in Lantana, FL
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.