Individual provider Active NPI

Chauntia Dimmings, APRN

  • Family Nurse Practitioner
  • Willoughby, OH
National Provider Identifier
1700426103
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
026169 Issued in OH
Practice address
6005 Som Center Rd
Willoughby, OH 44094-9646
Phone
(440) 946-7252
NPI assigned
Jan 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 026169 OH Primary

Addresses

Primary practice location

6005 Som Center Rd
Willoughby, OH 44094-9646

Mailing address

6005 Som Center Rd
Willoughby, OH 44094-9646
Phone (440) 946-7252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200331000128 OH Practitioner - Nurse Practitioner 4789013509 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
026169OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic Diagnostic of Ohio LLC Family CurrentSince Sep 18, 2020 Accepting new patients

Locations

4961 Roberts Rd
Hilliard, OH 43026
Phone (614) 850-2407

10085 Darrow Rd
Twinsburg, OH 44087
Phone (330) 425-4300

6005 Som Center Rd
Willoughby, OH 44094
Phone (440) 946-7252

28100 Chagrin Blvd
Woodmere, OH 44122
Phone (216) 591-0601

Organizations & group practices 1

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": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621555200000",
    "number": "1700426103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 SOM CENTER RD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440949646",
            "telephone_number": "440-946-7252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 SOM CENTER RD",
            "city": "WILLOUGHBY",
            "state": "OH",
            "postal_code": "440949646",
            "telephone_number": "440-946-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMMINGS",
        "first_name": "CHAUNTIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "026169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willoughby, OH

Sources for this page

Verify at the official NPI Registry.