Individual provider Active NPI

Nichole Jeanette Chamberlain, CRNP

  • Family Health Clinical Nurse Specialist
  • Bethesda, MD
National Provider Identifier
1962768952
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
License
R140138 Issued in MD
Practice address
9309 Old Georgetown Rd
Bethesda, MD 20814-1620
Phone
(301) 841-0836
Fax
(301) 493-8553
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X R140138 MD Primary

Addresses

Primary practice location

9309 Old Georgetown Rd
Bethesda, MD 20814-1620

Mailing address

10701 Kings Riding Way
101
Rockville, MD 20852-5419
Phone (202) 744-9242

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R140138MDMDFamily Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1962768952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 KINGS RIDING WAY",
            "address_2": "101",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208525419",
            "telephone_number": "202-744-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9309 OLD GEORGETOWN RD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208141620",
            "telephone_number": "301-841-0836",
            "fax_number": "301-493-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBERLAIN",
        "first_name": "NICHOLE",
        "middle_name": "JEANETTE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "MD",
            "license": "R140138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.