Rutuja Chinchankar, BHS
Individual provider Active NPI Peer Specialist · Bowling Green, KY
NPI 1609430271 · NPPES record last updated Apr 29, 2019
Key facts
- NPI
- 1609430271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- Practice address
- 380 Suwannee Trail St
Bowling Green, KY 42103-7956 - Phone
- (270) 901-5000
- Fax
- (270) 842-5268
- NPI assigned
- Apr 29, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | KY | Yes |
Addresses
Primary practice location
380 Suwannee Trail St
Bowling Green, KY 42103-7956
Mailing address
380 Suwannee Trail St
Bowling Green, KY 42103-7956
Phone (270) 901-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30604011 | Medicaid | KY |
NPI Registry JSON
{
"created_epoch": "1556496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556496000000",
"number": "1609430271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "380 SUWANNEE TRAIL ST",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421037956",
"telephone_number": "270-901-5000",
"fax_number": "270-842-5268"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 SUWANNEE TRAIL ST",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421037956",
"telephone_number": "270-901-5000",
"fax_number": "270-842-5268"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHINCHANKAR",
"first_name": "RUTUJA",
"credential": "BHS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-29",
"last_updated": "2019-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "KY",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30604011",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bowling Green, KY
- Chestnut Park Professionals, LLC
- Sandeep Chhabra
- Heather G Childress
- Shannon Childress
- Anne Chimera
- Sara L Chou
- Terry Chou
- Wesley H Chou
- Lillian Rebecca Chrisman
- Christian Care Communities, Inc.
All providers in Bowling Green, KY · Peer Specialist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.