Gertrude Chancellor, FNP-BC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

95007950 Issued in CA

Practice address

22481 Aspan St Ste a
Lake Forest, CA 92630-1648

Phone

(949) 240-2272

Fax

(949) 240-5869

NPI assigned

May 31, 2018

Last updated

Jun 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: gertrudechancellor@chcca.allscriptsdirect.net

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.

• Camino Health Center

  • Federally Qualified Health Center (FQHC)
  • Lake Forest, CA
  • NPI 1194274811
  NPD (past)

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1467944900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22481 ASPAN ST STE A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301648",
            "telephone_number": "949-240-2272",
            "fax_number": "949-240-5869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22481 ASPAN ST STE A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926301648",
            "telephone_number": "949-240-2272",
            "fax_number": "949-240-5869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27211 Puerta Del Oro",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "926914433",
            "country_code": "US",
            "telephone_number": "949-310-9792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANCELLOR",
        "first_name": "GERTRUDE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "95007950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raquel Chairez
• Mary M Chalaby
• Alexandrea Chambers
• Victoria Chambers
• Champion Health & Wellness Functional Nursing, P.C.
• Chandra Medina, Marriage and Family Therapy Inc (Thrive Recovery)
• Diem Chieu Chang, D.D.S.
• Eileen M Chang, LMFT
• Grace Chang, M.D., PH.D.
• Ku-Juey Raymond Chang, M.D.

• Family Medicine Physician in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.