Pelham B. Chastang

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PTH2770 Issued in AL

Legal business name

PELHAM B. CHASTANG

Doing business as

Buckaroo Barn, L. L. C.

Practice address

39821 Duffee LN
Bay Minette, AL 36507-6877

Phone

(251) 937-7600

Fax

(251) 937-7653

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Kristye Hall Chastang, RPT

Title

Physical Therapist

Phone

(251) 937-7600

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Buckaroo Barn, L. L. C. Doing business as

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023184587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39821 DUFFEE LN",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365076877",
            "telephone_number": "251-937-7600",
            "fax_number": "251-937-7653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39821 DUFFEE LN",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365076877",
            "telephone_number": "251-937-7600",
            "fax_number": "251-937-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELHAM B. CHASTANG",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHASTANG",
        "authorized_official_first_name": "KRISTYE",
        "authorized_official_middle_name": "HALL",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "251-937-7600",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AL",
            "license": "PTH2770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS FACILITY PROVIDER",
            "identifier": "51527691",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buckaroo Barn, L. L. C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatric Physical Therapist in Bay Minette, AL
• Providers in Bay Minette, AL by specialty
• Pediatric Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.