Individual provider Active NPI

Chandler Diffily, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Haverhill, MA
National Provider Identifier
1487270112
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2020011123 Issued in MA
Practice address
116 Summer St
Haverhill, MA 01830-6032
Phone
(978) 373-7010
NPI assigned
Jun 18, 2020
Last updated
Sep 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2020011123 MA Primary

Addresses

Primary practice location

116 Summer St
Haverhill, MA 01830-6032

Mailing address

116 Summer St
Haverhill, MA 01830-6032
Phone (978) 373-7010

Other identifiers 2

IdentifierTypeStateIssuer
2020011123OtherMAAMERICAN NURSES CREDENTIALING CENTER
RN2302027OtherMAMASSACHUSETTS BOARD OF NURSING

Other names 1

  • Ms. Chandler Knight Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20200930001961 MA Practitioner - Nurse Practitioner 5597184135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hri Clinics, Inc.Group PAC ID 8022088483, 104 clinicians

Practice addresses (Care Compare)

116 Summer St
Haverhill, MA 01830-6032
Phone (978) 373-7010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020011123MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CDPH Services LLC Current Accepting new patients
Hri Clinics, Inc. CurrentSince Jul 27, 2020 Accepting new patients
Hri Clinics Inc CurrentSince Jul 27, 2020 Accepting new patients

Locations

14 Fordham Rd
Boston, MA 02134
Phone (617) 783-9676

116 Summer St
Haverhill, MA 01830
Phone (978) 373-7010

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1592438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1487270112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 SUMMER ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306032",
            "telephone_number": "978-373-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 SUMMER ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306032",
            "telephone_number": "978-373-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIFFILY",
        "first_name": "CHANDLER",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-18",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "2020011123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSES CREDENTIALING CENTER",
            "identifier": "2020011123",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSETTS BOARD OF NURSING",
            "identifier": "RN2302027",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANDLER",
            "last_name": "KNIGHT",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Haverhill, MA

Sources for this page

Verify at the official NPI Registry.