Individual provider Active NPI

Chantal T Kabamba

  • Family Nurse Practitioner
  • Lancaster, PA
National Provider Identifier
1447895321
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP021024 Issued in PA
Practice address
304 N Water St
Lancaster, PA 17603-3374
Phone
(717) 299-6372
NPI assigned
Nov 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP021024 PA Primary

Addresses

Primary practice location

304 N Water St
Lancaster, PA 17603-3374

Mailing address

44 Springville Rd
Mount Joy, PA 17552-1216
Phone (717) 808-8210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200106000855 PA Practitioner - Nurse Practitioner 3274967922 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP021024PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Union Community Care CurrentSince Jan 1, 2020 Accepting new patients
Union Community Care Current Accepting new patients
Union Community Care CurrentSince Mar 1, 2021 Accepting new patients
Union Community Care CurrentSince Mar 1, 2021 Accepting new patients
Union Community Care CurrentSince Jan 1, 2020 Accepting new patients

Locations

304 N Water St
Lancaster, PA 17603
Phone (717) 299-6372

625 S Duke St
Lancaster, PA 17602
Phone (717) 299-6372

435 S Kinzer Ave
Ste 6
New Holland, PA 17557
Phone (717) 351-2400

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1447895321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 SPRINGVILLE RD",
            "city": "MOUNT JOY",
            "state": "PA",
            "postal_code": "175521216",
            "telephone_number": "717-808-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 N WATER ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176033374",
            "telephone_number": "717-299-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABAMBA",
        "first_name": "CHANTAL",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP021024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.