Active NPI
Anthony C Chavis, R.T. (T)
- Radiation Therapy Radiologic Technologist
- Spring Valley, CA
National Provider Identifier
1073771069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiation Therapy Radiologic Technologist
- License
- 84497
- Practice address
- 10767 Jamacha Blvd
Space 197
Spring Valley, CA 91978-1829 - Phone
- (619) 937-1164
- NPI assigned
- May 28, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiation Therapy Radiologic Technologist | 2471R0002X | 84497 | CA | Primary |
Addresses
Primary practice location
10767 Jamacha Blvd
Space 197
Spring Valley, CA 91978-1829
Mailing address
10767 Jamacha Blvd
Space 197
Spring Valley, CA 91978-1829
Phone (619) 937-1164
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
| License | State | Type | Specialty |
|---|---|---|---|
| 84497 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211932800000",
"number": "1073771069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10767 JAMACHA BLVD",
"address_2": "SPACE 197",
"city": "SPRING VALLEY",
"state": "CA",
"postal_code": "919781829",
"telephone_number": "619-937-1164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10767 JAMACHA BLVD",
"address_2": "SPACE 197",
"city": "SPRING VALLEY",
"state": "CA",
"postal_code": "919781829",
"telephone_number": "619-937-1164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVIS",
"first_name": "ANTHONY",
"middle_name": "C",
"credential": "R.T. (T)",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-28",
"last_updated": "2008-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "2471R0002X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiation Therapy",
"state": "CA",
"license": "84497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.