Active NPI
Centajiah Chantala Staten
- Nurse's Aide
- Milwaukee, WI
National Provider Identifier
1356019574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 390544
- Practice address
- 5474 N 56TH St
Milwaukee, WI 53218-3218 - Phone
- (414) 249-8974
- NPI assigned
- Sep 1, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 390544 | WI | Primary |
Addresses
Primary practice location
5474 N 56TH St
Milwaukee, WI 53218-3218
Mailing address
5474 N 56TH St
Milwaukee, WI 53218-3218
Phone (414) 249-8974
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
| License | State | Type | Specialty |
|---|---|---|---|
| 390544 | WI | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1356019574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5474 N 56TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532183218",
"telephone_number": "414-249-8974"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5474 N 56TH ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532183218",
"telephone_number": "414-249-8974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STATEN",
"first_name": "CENTAJIAH",
"middle_name": "CHANTALA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-01",
"last_updated": "2021-09-01",
"certification_date": "2021-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "WI",
"license": "390544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.