Individual provider Active NPI

Amanda Gayle Chambers, LPN

  • Licensed Practical Nurse
  • Carrollton, GA
National Provider Identifier
1346858644
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN097838 Issued in GA
Practice address
153 Independence Dr
Carrollton, GA 30116-9000
Phone
(770) 836-6678
Fax
(770) 830-2266
NPI assigned
Jul 22, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN097838 GA Primary

Addresses

Primary practice location

153 Independence Dr
Carrollton, GA 30116-9000

Mailing address

153 Independence Dr
Carrollton, GA 30116-9000
Phone (770) 836-6678

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
LPN097838GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1346858644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 INDEPENDENCE DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301169000",
            "telephone_number": "770-836-6678",
            "fax_number": "770-830-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 INDEPENDENCE DR",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301169000",
            "telephone_number": "770-836-6678",
            "fax_number": "770-830-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "AMANDA",
        "middle_name": "GAYLE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN097838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.