SHELLY CHANDLER NP NPI 1629055736

NPI Information

NPI: 1629055736
Provider Name: SHELLY CHANDLER, NP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: OPTIMUS HEALTH CARE INC

PECOS Registration: Yes

Address:
199 CHERRY ST
MILFORD, CT
ZIP 06460
Phone: (203) 874-2543
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Shelly Chandler, NP is a family nurse practitioner in Milford, CT with 7 years of experience. Shelly Chandler, NP NPI is 1629055736. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

199 CHERRY ST
MILFORD, CT
ZIP 06460-501
Phone: (203) 874-2543
Fax: (203) 874-2544

The NPI 1629055736 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/29/2005 and was last updated on 1/27/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363L00000X	Nurse Practitioner		254081	MASSACHUSETTS	No
2	363LF0000X	Nurse Practitioner	Family	3007254	KENTUCKY	No
3	363LF0000X	Nurse Practitioner	Family	2012029067	MISSOURI	No
4	363LF0000X	Nurse Practitioner	Family	12.007315	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NP4179	OTHER	MASSACHUSETTS	BLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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