Active NPI
Demia Chandler, MENTAL HEALTH TECH
- Nurse's Aide
- Gary, IN
National Provider Identifier
1588036974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- CNA0806442
- Practice address
- 4747 W 24TH Ave
Gary, IN 46406-2821 - Phone
- (219) 240-8615
- Fax
- (219) 977-1197
- NPI assigned
- Oct 24, 2015
- Last updated
- Oct 24, 2015
- 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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | CNA0806442 | IN | Primary |
Addresses
Primary practice location
4747 W 24TH Ave
Gary, IN 46406-2821
Mailing address
4747 W 24TH Ave
Gary, IN 46406-2821
Phone (219) 240-8615
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 |
|---|---|---|---|
| CNA0806442 | IN | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445644800000",
"number": "1588036974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4747 W 24TH AVE",
"city": "GARY",
"state": "IN",
"postal_code": "464062821",
"telephone_number": "219-240-8615",
"fax_number": "219-977-1197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4747 W 24TH AVE",
"city": "GARY",
"state": "IN",
"postal_code": "464062821",
"telephone_number": "219-240-8615",
"fax_number": "219-977-1197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANDLER",
"first_name": "DEMIA",
"credential": "MENTAL HEALTH TECH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-10-24",
"last_updated": "2015-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "IN",
"license": "CNA0806442",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gary, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.