Active NPI
Chantel Bannerman, BACHELORS
- Counselor
- Pawtucket, RI
National Provider Identifier
1487085890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 101 Bacon St
Pawtucket, RI 02860-5542 - Phone
- (401) 724-8400
- Fax
- (401) 722-5280
- NPI assigned
- Dec 11, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
101 Bacon St
Pawtucket, RI 02860-5542
Mailing address
101 Bacon St
Pawtucket, RI 02860-5542
Phone (401) 724-8400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GH57134 | Medicaid | RI |
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": "1386720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386720000000",
"number": "1487085890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 BACON ST",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028605542",
"telephone_number": "401-724-8400",
"fax_number": "401-722-5280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BACON ST",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028605542",
"telephone_number": "401-724-8400",
"fax_number": "401-722-5280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANNERMAN",
"first_name": "CHANTEL",
"credential": "BACHELORS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-11",
"last_updated": "2013-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GH57134",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pawtucket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.