Individual provider Active NPI

Sophia Bonnetia Chandler, ACNS-BC

  • Adult Health Clinical Nurse Specialist
  • Memphis, TN
National Provider Identifier
1275615429
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
0386613 Issued in TN
Practice address
1030 Jefferson Ave
Memphis, TN 38104-2127
Phone
(901) 523-8990
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 0386613 TN Primary

Addresses

Primary practice location

1030 Jefferson Ave
Memphis, TN 38104-2127

Mailing address

136 Pennsylvania Ave
Munford, TN 38058-6159
Phone (270) 559-8418

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
0386613TNMDAdult Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1275615429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 PENNSYLVANIA AVE",
            "city": "MUNFORD",
            "state": "TN",
            "postal_code": "380586159",
            "telephone_number": "270-559-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381042127",
            "telephone_number": "901-523-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "SOPHIA",
        "middle_name": "BONNETIA",
        "credential": "ACNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "TN",
            "license": "0386613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.