Judith Lynn Chantelois, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

0101245734 Issued in VA

Practice address

800 Oak St
Farmville, VA 23901-1199

Phone

(434) 315-2950

Fax

(434) 392-8272

NPI assigned

May 26, 2006

Last updated

Oct 15, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Centra Medical Group Southside, LLC

  • Family Medicine Physician
  • Farmville, VA
  • NPI 1841479565
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318636800000",
    "number": "1548216088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 927",
            "address_2": "5 E. ALVON ROAD, SUITE 7",
            "city": "WHITE SULPHUR SPRINGS",
            "state": "WV",
            "postal_code": "249862373",
            "telephone_number": "304-536-5030",
            "fax_number": "304-536-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OAK ST",
            "city": "FARMVILLE",
            "state": "VA",
            "postal_code": "239011199",
            "telephone_number": "434-315-2950",
            "fax_number": "434-392-8272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANTELOIS",
        "first_name": "JUDITH",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2011-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "43193",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101245734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34112000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Centra Pace - Farmville (Centra PACE)
• Central Virginia Health Services Inc (CVHS Farmville)
• Mikaela Chambers, PT, DPT
• Amanda Elizabeth Chandler, CCC-SLP
• Sharon Chandler, NP
• Elizabeth Chassey, LPC
• Joe Chen
• Chest Diseases and Internal Medicine, P.C.
• Joel Clark I, COTA
• Sherry Clark, LPC

• Obstetrics & Gynecology Physician in Farmville, VA
• Providers in Farmville, VA by specialty
• Obstetrics & Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.