Courtney Brianna Chipangama, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP050589 Issued in AZ

Practice address

2301 W Thomas Rd
Phoenix, AZ 85015-5904

Phone

(602) 257-3882

NPI assigned

Nov 17, 2017

Last updated

Nov 17, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510876800000",
    "number": "1275047805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1825 N MEADOW LARK DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850155904",
            "telephone_number": "602-257-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIPANGAMA",
        "first_name": "COURTNEY",
        "middle_name": "BRIANNA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "050589",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP050589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Licensed Practical Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.