Sara Brooke Canchola, APRN

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

3006713 Issued in KY

Practice address

4010 Dupont Cir Ste L07
Louisville, KY 40207-4812

Phone

(502) 895-6559

Fax

(502) 895-8994

NPI assigned

Dec 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• All Women OB/GYN, PSC

  • Obstetrics & Gynecology Physician
  • Louisville, KY
  • NPI 1902880990
  NPD

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1215230446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE L07",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074812",
            "telephone_number": "502-895-6559",
            "fax_number": "502-895-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 DUPONT CIR STE L07",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074812",
            "telephone_number": "502-895-6559",
            "fax_number": "502-895-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCHOLA",
        "first_name": "SARA",
        "middle_name": "BROOKE",
        "name_prefix": "Miss",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-09",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KY",
            "license": "3006713",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "KY",
            "license": "3006713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dericka Canada
• Caitlin Michele Canapinno, OTR/L
• Audrey Joie Canary, APRN
• Edward L Canary II
• Alessandro Cancelliere, M.D.
• Adriana Carolina Candelaria Jimenez
• Ismael Candelario Fernandez
• Cane Run Chiropractic Center, PLLC
• Cane Run Chiropractic, PSC
• Cane Run Smile Center, Inc.

• Obstetrics & Gynecology Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Obstetrics & Gynecology Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.