Individual provider Active NPI

Kimberly Chanda Safford

  • Registered Nurse
  • Chicago, IL
National Provider Identifier
1245961317
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041.332480 Issued in IL
Practice address
441 W 103Rd PL
Chicago, IL 60628-2405
Phone
(312) 905-3088
NPI assigned
Jun 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041.332480 IL Primary

Addresses

Primary practice location

441 W 103Rd PL
Chicago, IL 60628-2405

Mailing address

441 W 103Rd PL
Chicago, IL 60628-2405
Phone (312) 905-3088

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@holistichomecare.agency Direct

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
041.332480ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1245961317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 W 103RD PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606282405",
            "telephone_number": "312-905-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 W 103RD PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606282405",
            "telephone_number": "312-905-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFFORD",
        "first_name": "KIMBERLY",
        "middle_name": "CHANDA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.332480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@holistichomecare.agency",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "info@holistichomecare.agency",
            "address_1": "441 W 103rd Pl",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606282405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.