Individual provider Active NPI

Chanae Aapri Gholston, LPN

  • Licensed Practical Nurse
  • West Haven, CT
National Provider Identifier
1477072007
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
32990 Issued in CT
Practice address
950 Campbell Ave
West Haven, CT 06516-2770
Phone
(203) 932-5711
NPI assigned
Sep 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 32990 CT Primary

Addresses

Primary practice location

950 Campbell Ave
West Haven, CT 06516-2770

Mailing address

47 Quinnipiac CT
New Haven, CT 06513-1733
Phone (293) 901-4018

Other practice location 1

181 Clifton St
New Haven, CT 06513-3319
Phone (203) 907-3550

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
32990CTMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1477072007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 QUINNIPIAC CT",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065131733",
            "telephone_number": "293-901-4018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CAMPBELL AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065162770",
            "telephone_number": "203-932-5711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 Clifton St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065133319",
            "country_code": "US",
            "telephone_number": "203-907-3550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHOLSTON",
        "first_name": "CHANAE",
        "middle_name": "AAPRI",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CT",
            "license": "32990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.