Active NPI
Inxs M Fiodembo
- Family Nurse Practitioner
- San Jose, CA
National Provider Identifier
1164970844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP95008817
- Practice address
- 685 Coleman Ave
San Jose, CA 95110-2011 - Phone
- (800) 972-5547
- NPI assigned
- Sep 12, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN.361495 | OH | |
| Family Nurse Practitioner | 363LF0000X | NP95008817 | CA | Primary |
Addresses
Primary practice location
685 Coleman Ave
San Jose, CA 95110-2011
Mailing address
325 Distel Cir
Los Altos, CA 94022-1408
Phone (800) 972-5547
Other practice location 1
987 E Hillsdale Blvd
Foster City, CA 94404-2112
Phone (650) 570-4631
Other practice location 2
1100 W Town and Country Rd Ste 1600
Orange, CA 92868
Phone (844) 310-2247
Other names 1
- Inxs M Chandler
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP95008817 | CA | MD | Family Nurse Practitioner |
| RN.361495 | OH | MD | Family Nurse Practitioner |
Interoperability endpoints
- ichandler448059@hisp.ehr.sutterhealth.org
- inxs.fiodembo.1@19661.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591142400000",
"number": "1164970844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 DISTEL CIR",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940221408",
"telephone_number": "800-972-5547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "685 COLEMAN AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951102011",
"telephone_number": "800-972-5547"
}
],
"practiceLocations": [
{
"address_1": "987 E Hillsdale Blvd",
"address_purpose": "LOCATION",
"city": "Foster City",
"state": "CA",
"postal_code": "944042112",
"country_code": "US",
"telephone_number": "650-570-4631",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1100 W Town and Country Rd Ste 1600",
"address_purpose": "LOCATION",
"city": "Orange",
"state": "CA",
"postal_code": "92868",
"country_code": "US",
"telephone_number": "844-310-2247",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FIODEMBO",
"first_name": "INXS",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-12",
"last_updated": "2020-06-03",
"certification_date": "2020-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "RN.361495",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "NP95008817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "INXS",
"last_name": "CHANDLER",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.