Individual provider Active NPI

Anthony Trevor Chenot, SURFACE IDC

  • Independent Duty Corpsman
  • San Diego, CA
National Provider Identifier
1396147468
Registry record updated Sep 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
8236 Station Village LN
Apartment 1809
San Diego, CA 92108-5560
Phone
(702) 596-1244
NPI assigned
Sep 20, 2014
Last updated
Sep 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X CA Primary

Addresses

Primary practice location

8236 Station Village LN
Apartment 1809
San Diego, CA 92108-5560

Mailing address

8236 Station Village LN
Apartment 1809
San Diego, CA 92108-5560
Phone (702) 596-1244

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

NPI Registry JSON

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

{
    "created_epoch": "1411171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411171200000",
    "number": "1396147468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8236 STATION VILLAGE LN",
            "address_2": "APARTMENT 1809",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085560",
            "telephone_number": "702-596-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8236 STATION VILLAGE LN",
            "address_2": "APARTMENT 1809",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921085560",
            "telephone_number": "702-596-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENOT",
        "first_name": "ANTHONY",
        "middle_name": "TREVOR",
        "credential": "SURFACE IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-20",
        "last_updated": "2014-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2014; 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.