Structured Chaos

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

STRUCTURED CHAOS

Practice address

700 Marsh Grass Dr
Raleigh, NC 27610-2194

Phone

(919) 389-7686

NPI assigned

Apr 27, 2021

Organization subpart

No

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

Authorized official

Name

Candace JennetteNPI 1073195327

Title

Owner

Phone

(919) 389-7686

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Candace Charlisa Jennette, MASTER'S EDUCATION

  • Early Intervention Provider Agency
  • Raleigh, NC
  • NPI 1073195327
  NPD Authorized official

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

{
    "created_epoch": "1619481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1366024465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 MARSH GRASS DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102194",
            "telephone_number": "919-389-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 MARSH GRASS DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276102194",
            "telephone_number": "919-389-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRUCTURED CHAOS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "JENNETTE",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-389-7686"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Everette L Stroman III
• Strong Families, Inc.
• Nancy Strong, CCC-SLP
• Grace R Stroud, M.A.
• Khaliyah Stroud, LCMHC
• Edith Johanna Struik, PAC
• David Poran Strum, MD
• Samantha Struzyk, OTR/L
• Cathryn Stryker, MED, CCC-SLP
• Nicole Cort Stuart, PA-C

• Early Intervention Provider Agency in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Early Intervention Provider Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.

Verify at the official NPI Registry.