Active NPI
Taylor Chavez, DPT
- Physical Therapist
- Phoenix, AZ
National Provider Identifier
1104488147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 17233 N Holmes Blvd Ste 1650
Phoenix, AZ 85053-2030 - Phone
- (602) 547-1836
- NPI assigned
- Jun 29, 2019
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | AZ | Primary |
Addresses
Primary practice location
17233 N Holmes Blvd Ste 1650
Phoenix, AZ 85053-2030
Mailing address
11954 Bluebird TRL
Plymouth, IN 46563-8486
Phone (701) 822-2083
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CP000408T | Other | AZ | LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2350 | ND | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strength Training Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Customized Equipment (DME)
- Phoenix, AZ
- NPI 1356552996
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564617600000",
"number": "1104488147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11954 BLUEBIRD TRL",
"city": "PLYMOUTH",
"state": "IN",
"postal_code": "465638486",
"telephone_number": "701-822-2083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17233 N HOLMES BLVD STE 1650",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850532030",
"telephone_number": "602-547-1836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ",
"first_name": "TAYLOR",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-29",
"last_updated": "2019-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "CP000408T",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.