Individual provider Active NPI

Inxs M Fiodembo

  • Family Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1164970844
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95008817 Issued in CA
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

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 Former name

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

LicenseStateTypeSpecialty
NP95008817CAMDFamily Nurse Practitioner
RN.361495OHMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: ichandler448059@hisp.ehr.sutterhealth.org
  • Direct secure messaging: 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.

Verify at the official NPI Registry.