Active NPI
Tamara Chinikaylo, CRNP
- Family Nurse Practitioner
- Wilkes Barre, PA
National Provider Identifier
1811326119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- SP013146
- Practice address
- 25 Church St
Wilkes Barre, PA 18702-3507 - Phone
- (877) 507-4957
- Fax
- (866) 810-6910
- NPI assigned
- Nov 6, 2013
- Last updated
- Jan 17, 2014
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | SP013146 | PA | Primary |
Addresses
Primary practice location
25 Church St
Wilkes Barre, PA 18702-3507
Mailing address
25 Church St
Wilkes Barre, PA 18765-0999
Phone (570) 808-3410
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP013146 | PA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389916800000",
"number": "1811326119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 CHURCH ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187650999",
"telephone_number": "570-808-3410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 CHURCH ST",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187023507",
"telephone_number": "877-507-4957",
"fax_number": "866-810-6910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHINIKAYLO",
"first_name": "TAMARA",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-06",
"last_updated": "2014-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SP013146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilkes Barre, PA
- Children's Service Center of Wyoming Valley, Inc
- Children's Service Center of Wyoming Valley, Inc
- Children's Service Center of Wyoming Valley, Inc
- Children's Service Center of Wyoming Valley, Inc
- Matthew Chin, M.D.
- Marissa Chiumento, PHARM.D
- Alexis Amber Chlada, PHARMD
- Hannah Chocallo, PA-C
- Daniel S Christian, M.D.
- Lora Ann Chronowski
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.