Active NPI
Chandra Devi Jaya Kantor, ARNP
- Nurse Practitioner
- Vero Beach, FL
National Provider Identifier
1821023995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 2173832
- Practice address
- 3715 7TH Ter
Vero Beach, FL 32960-6571 - Phone
- (772) 770-2664
- Fax
- (772) 770-3506
- NPI assigned
- Jul 11, 2006
- 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 Practitioner | 363L00000X | 2173832 | FL | Primary |
Addresses
Primary practice location
3715 7TH Ter
Vero Beach, FL 32960-6571
Mailing address
3715 7TH Terrace
Vero Beach, FL 32960
Phone (772) 770-2664
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 303173000 | Medicaid | FL |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2173832 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248652800000",
"number": "1821023995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3715 7TH TERRACE",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "32960",
"telephone_number": "772-770-2664",
"fax_number": "772-770-3506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3715 7TH TER",
"city": "VERO BEACH",
"state": "FL",
"postal_code": "329606571",
"telephone_number": "772-770-2664",
"fax_number": "772-770-3506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANTOR",
"first_name": "CHANDRA",
"middle_name": "DEVI JAYA",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2009-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "2173832",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "303173000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vero Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.