Active NPI
Chantale St Fort
- Licensed Practical Nurse
- Brooklyn, NY
National Provider Identifier
1518479286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 330530
- Practice address
- 120 Kenilworth PL Apt 6D
Brooklyn, NY 11210-2448 - Phone
- (917) 500-3805
- NPI assigned
- Nov 2, 2017
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 330530 | NY | Primary |
Addresses
Primary practice location
120 Kenilworth PL Apt 6D
Brooklyn, NY 11210-2448
Mailing address
120 Kenilworth PL Apt 6D
Brooklyn, NY 11210-2448
Phone (917) 500-3805
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 858-037-886 | Other | NY | NYS LEARNING PERMIT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 330530 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1518479286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 KENILWORTH PL APT 6D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112102448",
"telephone_number": "917-500-3805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 KENILWORTH PL APT 6D",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112102448",
"telephone_number": "917-500-3805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ST FORT",
"first_name": "CHANTALE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-02",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "330530",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS LEARNING PERMIT",
"identifier": "858-037-886",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.