Tactical Performance Physio LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

TACTICAL PERFORMANCE PHYSIO LLC

Practice address

130 Twin Oaks PL
Cary, NC 27511-5566

Phone

(845) 527-4103

NPI assigned

Jul 26, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Blaze Charles Chatham, PT, DPTNPI 1043642028

Title

Owner/Founder

Phone

(845) 527-4103

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blaze Charles Chatham, DPT, CSCS

  • Orthopedic Physical Therapist
  • Milford, MA
  • NPI 1043642028

  Physical Therapist

  NPD Authorized official

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1104655448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 TWIN OAKS PL",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275115566",
            "telephone_number": "845-527-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 TWIN OAKS PL",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275115566",
            "telephone_number": "845-527-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TACTICAL PERFORMANCE PHYSIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "CHATHAM",
        "authorized_official_first_name": "BLAZE",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER/FOUNDER",
        "authorized_official_telephone_number": "845-527-4103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T&C Transportation Services, LLC
• Seth Edward Tabb, M.D.
• Brandon Frederick Tabbutt, DPT
• Jennifer Arms Taber, DPT, MS, CSCS
• Rita Michelle Tabron, FNP
• Sowjanya Tadakapalli, D.M.D, CAGS
• Joseph C Tahan
• Samira Said Tahtawi, M.D.
• Tailwind Care, LLC
• Hafza Taimoor, DDS

• All providers in Cary, NC
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.