Individual provider Active NPI

Chandra Laureen Hollins, STNA

  • Nurse's Aide
  • Canal Winchester, OH
National Provider Identifier
1336357664
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
400394510804 Issued in OH
Practice address
6311 Fence Row LN
Canal Winchester, OH 43110-9787
Phone
(614) 920-2844
NPI assigned
May 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 400394510804 OH Primary

Addresses

Primary practice location

6311 Fence Row LN
Canal Winchester, OH 43110-9787

Mailing address

6311 Fence Row LN
Canal Winchester, OH 43110-9787
Phone (614) 920-2844

Other identifiers 1

IdentifierTypeStateIssuer
2713022MedicaidOH

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
400394510804OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1336357664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6311 FENCE ROW LN",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431109787",
            "telephone_number": "614-920-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6311 FENCE ROW LN",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431109787",
            "telephone_number": "614-920-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINS",
        "first_name": "CHANDRA",
        "middle_name": "LAUREEN",
        "name_prefix": "Ms.",
        "credential": "STNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "400394510804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2713022",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canal Winchester, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.