Desiree Montanari Challice I, P.T., DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT16878 Issued in FL

Practice address

19 Old Kings Rd N Ste C107
Palm Coast, FL 32137-8261

Phone

(386) 445-2348

Fax

(386) 269-4907

NPI assigned

Apr 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Functional Integrative Training, Inc.

  dba Peak Fitness and Rehab

  • Physical Therapist
  • Palm Coast, FL
  • NPI 1669697413
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1063637809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 354932",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321354932",
            "telephone_number": "386-445-2348",
            "fax_number": "386-269-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 OLD KINGS RD N STE C107",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378261",
            "telephone_number": "386-445-2348",
            "fax_number": "386-269-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALLICE",
        "first_name": "DESIREE",
        "middle_name": "MONTANARI",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "P.T., DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2021-12-13",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT16878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Cavinta, LMHC
• Jecebu Josol Ceballos, M.D.
• Centered in Compassion Counseling LLC
• Cerrato Associates Incorporation
• Bonnie Marie Chalker, O.D.
• Chamion N. Olivier MD PA
• Cassandra Chamoun, APRN
• Chandler Medical, PLLC
• William Chandler, CRNA
• Derek Blake Charles

• Physical Therapist in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.