CHANTA MCKINLEY (AGACNP-BC, RN) – Nurse Practitioner, NPI 1639807423

CHANTA MCKINLEY (AGACNP-BC, RN) is a healthcare provider. based in Cleveland, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials AGACNP-BC, RN. They hold a License No. 0031943 (OH). The NPI Number for CHANTA MCKINLEY (AGACNP-BC, RN) is 1639807423

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
CHANTA MCKINLEY (AGACNP-BC, RN)
NPI
1639807423
Phone
(216) 791-3800
Address
10701 EAST BLVD
Enumeration Date
10 August 2022
Last Update Date
15 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4197241414
Graduation Year
2021 (5 years ago)
PAC ID
5395103527
Group Practice PAC ID
8729453436
Professional Enrollment ID
I20230621001384
Address ID
OH436051544TO131XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

Provider Addresses for CHANTA MCKINLEY (AGACNP-BC, RN)

  • 10701 EAST BLVD

    CLEVELAND, OH 441061702

    Phone: (216) 791-3800

    Type: Location

  • PO BOX 417

    TUSCUMBIA, AL 356740417

    Phone: (216) 245-7663

    Type: Mailing

  • 20 SOUTH 3RD ST

    COLUMBUS, OH 43215

    Phone: (216) 245-7663

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-06-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230621001384INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44106)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8729453436View full group profile
NameSpecialtyState
Nurse PractitionerMI
Nurse PractitionerTX
Nurse PractitionerIL
Nurse PractitionerMN
Nurse PractitionerTX
Nurse PractitionerGA
Nurse PractitionerMI
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerFL

Reviews

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Frequently asked questions

Can I verify CHANTA MCKINLEY (AGACNP-BC, RN) with an NPI only?
You can start verification with NPI 1639807423 for CHANTA MCKINLEY (AGACNP-BC, RN), then check state licensing separately.
Can I rely on CHANTA MCKINLEY (AGACNP-BC, RN) being an active provider?
As of the registry snapshot, CHANTA MCKINLEY (AGACNP-BC, RN) is marked active.
What is CHANTA MCKINLEY (AGACNP-BC, RN)'s primary classification?
Nurse Practitioner is the headline specialty for CHANTA MCKINLEY (AGACNP-BC, RN) here. Clinical services aligned with this taxonomy classification.
What address line appears for CHANTA MCKINLEY (AGACNP-BC, RN)?
CHANTA MCKINLEY (AGACNP-BC, RN)'s geographic hint is Cleveland, Ohio in our summary view.
Why does CHANTA MCKINLEY (AGACNP-BC, RN) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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