Individual provider Active NPI

Caroline Chantry, M.D.

  • Pediatrics Physician
  • Sacramento, CA
National Provider Identifier
1508849167
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G60694 Issued in CA
Practice address
2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone
(916) 734-4455
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G60694 CA Primary

Addresses

Primary practice location

2315 Stockton Blvd
Sacramento, CA 95817-2201

Mailing address

2315 Stockton Blvd
Sacramento, CA 95817-2201
Phone (916) 734-4455

Other identifiers 1

IdentifierTypeStateIssuer
00G606940OtherCAMEDICAL NUMBER

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100428000505 CA Practitioner - Pediatric Medicine 8123155843 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G60694CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Feb 17, 2010 Accepting new patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of Ca Pediatrics CurrentSince Feb 17, 2010 Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

2261 Douglas Blvd
Roseville, CA 95661
Phone (916) 783-1044

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

4900 Broadway
Ste 2800
Sacramento, CA 95820
Phone (916) 734-9313

2315 Stockton Blvd
Sacramento, CA 95817
Phone (916) 703-3030

2521 Stockton Blvd
Ste 2200
Sacramento, CA 95817
Phone (916) 734-1180

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322611200000",
    "number": "1508849167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172201",
            "telephone_number": "916-734-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANTRY",
        "first_name": "CAROLINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2011-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G60694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL NUMBER",
            "identifier": "00G606940",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.