Nicole Lynn Chambers, CPNP-AC

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

4704345775 Issued in MI

Practice address

3901 Beaubien St
Detroit, MI 48201-2196

Phone

(734) 625-6948

NPI assigned

Mar 11, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI, OH2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Wayne State University School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metro Infectious Disease Consultants LLC 386 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1235125717

  MI, OH

  Medicare reassignment Care Compare group
• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1811920549

  MI

  Medicare reassignment NPD
• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Plymouth, MI
  • NPI 1841530250
  Care Compare group NPD (past)
• Metro Infectious Disease Consultants LLC

  • Infectious Disease Physician
  • Jonesboro, GA
  • NPI 1770307191
  Care Compare group
• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Huntsville, AL
  • NPI 1659702223
  Care Compare group
• University Pediatricians

  • Pediatrics Physician
  • Detroit, MI
  • NPI 1184471690
  NPD

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

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1710635552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3447 CONSEAR RD",
            "city": "LAMBERTVILLE",
            "state": "MI",
            "postal_code": "481449752",
            "telephone_number": "734-625-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012196",
            "telephone_number": "734-625-6948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3447 Consear Rd",
            "address_purpose": "LOCATION",
            "city": "Lambertville",
            "state": "MI",
            "postal_code": "481449752",
            "country_code": "US",
            "telephone_number": "734-625-6948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMBERS",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-11",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "MI",
            "license": "4704345775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN BOARD OF NURSING",
            "identifier": "4704345775",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Felicia Chambers-Funchess IV, LMSW
• Candiss Letice Chambers
• Carolyn Lee Chambers
• Gladys S Chambers
• Jillian Beth Chambers, CCC-SLP
• Ryan Chambers
• Kaelyn Jean Chambless, NP
• Aghiad Chamdin, MD
• Sarah Chamdin
• Chanel Perkovic Chami, DO

• All providers in Detroit, MI
• Critical Care Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.