Individual provider Active NPI

Chevonda Bantley, LPN

  • Licensed Practical Nurse
  • Cincinnati, OH
National Provider Identifier
1407567688
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
161028 Issued in OH
Practice address
3706 Monfort Heights Dr
Cincinnati, OH 45247-8024
Phone
(513) 693-1002
NPI assigned
Dec 8, 2022
Last updated
Dec 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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 161028 OH Primary

Addresses

Primary practice location

3706 Monfort Heights Dr
Cincinnati, OH 45247-8024

Mailing address

3706 Monfort Heights Dr
Cincinnati, OH 45247-8024
Phone (513) 693-1002

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
161028OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
5Heartbeatsllc Licensed Practical Nurse CurrentSince Dec 18, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1407567688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3706 MONFORT HEIGHTS DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452478024",
            "telephone_number": "513-693-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3706 MONFORT HEIGHTS DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452478024",
            "telephone_number": "513-693-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANTLEY",
        "first_name": "CHEVONDA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "161028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.