Individual provider Active NPI

Ravin Michelle Chase

  • Physical Therapist
  • South Daytona, FL
National Provider Identifier
1083875488
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
029346 Issued in NY
Practice address
917 Beville Rd
Ste G
South Daytona, FL 32119-1712
Phone
(386) 756-4395
Fax
(866) 426-2811
NPI assigned
Jun 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 029346 NY Primary

Addresses

Primary practice location

917 Beville Rd
Ste G
South Daytona, FL 32119-1712

Mailing address

229 Parkville Ave
Apt. 4E
Brooklyn, NY 11230-1373

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

LicenseStateTypeSpecialty
029346NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1083875488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 PARKVILLE AVE",
            "address_2": "APT. 4E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112301373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 BEVILLE RD",
            "address_2": "STE G",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191712",
            "telephone_number": "386-756-4395",
            "fax_number": "866-426-2811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASE",
        "first_name": "RAVIN",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.

Verify at the official NPI Registry.