Active NPI
Chandra Leeann Carothers, PA-C
- Physician Assistant
- Beckley, WV
National Provider Identifier
1497174841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1112704
- Practice address
- 250 Stanaford Rd
Beckley, WV 25801-3140 - Phone
- (304) 254-2600
- NPI assigned
- Apr 14, 2014
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1112704 | WV | Primary |
Addresses
Primary practice location
250 Stanaford Rd
Beckley, WV 25801-3140
Mailing address
250 Stanaford Rd
Beckley, WV 25801-3140
Phone (304) 254-2600
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1112704 | WV | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397433600000",
"number": "1497174841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 STANAFORD RD",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258013140",
"telephone_number": "304-254-2600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 STANAFORD RD",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258013140",
"telephone_number": "304-254-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAROTHERS",
"first_name": "CHANDRA",
"middle_name": "LEEANN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-14",
"last_updated": "2014-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WV",
"license": "1112704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.