Embold Foot Care LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

EMBOLD FOOT CARE LLC

Practice address

981 3600 Ave
Abilene, KS 67410-6044

Phone

(785) 479-6401

NPI assigned

Jan 16, 2023

Organization subpart

No

Name

Chantell Debenham, APRNNPI 1215247416

Title

Owner/Provider

Phone

(785) 576-9990

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chantell Renee Debenham, ARNP

  • Nurse Practitioner
  • Abilene, KS
  • NPI 1215247416

  KS

  Medicare reassignment NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 2, 2023.

{
    "created_epoch": "1673827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1831804764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 3600 AVE",
            "city": "ABILENE",
            "state": "KS",
            "postal_code": "674106044",
            "telephone_number": "785-576-9990",
            "fax_number": "785-576-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981 3600 AVE",
            "city": "ABILENE",
            "state": "KS",
            "postal_code": "674106044",
            "telephone_number": "785-479-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBOLD FOOT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "DEBENHAM",
        "authorized_official_first_name": "CHANTELL",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "785-576-9990",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1215247416",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdebenham@emboldllc.com",
            "affiliation": "N",
            "address_1": "981 3600 Ave",
            "city": "Abilene",
            "state": "KS",
            "country_code": "US",
            "postal_code": "674106044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• County of Dickinson Office of County Clerk
• Cuba Chiropractic PA
• Michael J. Cuba, DC
• Chantell Renee Debenham, ARNP
• Ashly Doering, APRN
• Brandi Erichsen, O.D.
• Evizzit of Kansas Psychiatry PA
• Family Care Clinic, PA
• Deann Feldt, N.P.
• Erica Forbes, NP

• All providers in Abilene, KS
• Family Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.