Individual provider Active NPI

Chauncey Denise Tarrant, M.D.

  • Pediatrics Physician
  • Scott AFB, IL
National Provider Identifier
1154646156
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
26470 Issued in NE
Practice address
310 W Losey St
Scott AFB, IL 62225-5250
Phone
(618) 256-7018
NPI assigned
Apr 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 26470 NE Primary

Addresses

Primary practice location

310 W Losey St
Scott AFB, IL 62225-5250

Mailing address

310 W Losey St
Scott AFB, IL 62225-5250
Phone (618) 256-7018

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170206001151 MO Practitioner - Pediatric Medicine 4486937091 Reassigns benefits to 5 organizations
I20170901000621 IL Practitioner - Pediatric Medicine 4486937091 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
26470NEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Cardinal Glennon Childrens Hospital Pediatrics Current Accepting new patients
Mercy Hospital Lincoln Current Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 25, 2019 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 25, 2019 Accepting new patients
SSM Cardinal Glennon Children's Hospital Pediatrics CurrentSince Jan 3, 2017 Accepting new patients
SSM Health Care St Louis CurrentSince Jan 3, 2017 Accepting new patients
Mercy Hospitals East Communities CurrentSince Aug 25, 2019 Accepting new patients
SSM Cardinal Glennon Childrens Hospital Pediatrics CurrentSince Jan 3, 2017 Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

Organizations & group practices 8

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": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1154646156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W LOSEY ST",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "622255250",
            "telephone_number": "618-256-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W LOSEY ST",
            "city": "SCOTT AFB",
            "state": "IL",
            "postal_code": "622255250",
            "telephone_number": "618-256-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARRANT",
        "first_name": "CHAUNCEY",
        "middle_name": "DENISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "26470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scott AFB, IL

Sources for this page

Verify at the official NPI Registry.