Jacob A Chavez, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA.0015038 Issued in CO

Practice address

901 N Santa Fe Ave
Fountain, CO 80817-1738

Phone

(719) 822-0550

NPI assigned

Nov 6, 2024

Last updated

Nov 6, 2024By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1093538134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 JACKSON ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042471",
            "telephone_number": "719-553-6949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N SANTA FE AVE",
            "city": "FOUNTAIN",
            "state": "CO",
            "postal_code": "808171738",
            "telephone_number": "719-822-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "JACOB",
        "middle_name": "A",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA.0015038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Castro
• Cassandra Casul, FNP
• Catholic Health Initiatives Colorado (Ucfn Urgent Care)
• Leslie Katherine Chaffin, DPT
• Sydney Ann Chappell
• Cheyenne Mountain Modern Dentistry, LLP (Cheyenne Mountain Modern Dentistry and Orthodontics)
• Chuckies Place
• City of Fountain (City of Fountain EMS)
• Rebecca Lee Claros, LCSW
• Ashley Collins, PT

• Physical Therapy Assistant in Fountain, CO
• Providers in Fountain, CO by specialty
• Physical Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.