Active NPI
Fabian Chavez
- Physical Therapist
- Chandler, AZ
National Provider Identifier
1124134713
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7454
- Practice address
- 1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224-5225 - Phone
- (480) 821-1997
- Fax
- (480) 821-1887
- NPI assigned
- Aug 23, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | |||
| Physical Therapist | 225100000X | 7454 | AZ | Primary |
Addresses
Primary practice location
1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224-5225
Mailing address
1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224-5225
Phone (480) 821-1997
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21223 | Other | FL | LICENSE # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1076 W Chandler Blvd
Suite 103
Chandler, AZ 85224-5223
Phone (480) 821-1997
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7454 | AZ | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 360 Physical Therapy LLC | Physical Therapist | Current | Accepting new patients |
| 360 Physical Therapy, LLC | Current | Accepting new patients |
Locations
1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224
Phone 4808211997116
4210 E Baseline Rd
Ste 106
Mesa, AZ 85206
Phone (480) 503-2373
Organizations & group practices 2
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.
-
- Specialist
- Scottsdale, AZ
- NPI 1932430949
-
- Physical Therapist
- Queen Creek, AZ
- NPI 1689115164
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333929600000",
"number": "1124134713",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1076 W CHANDLER BLVD",
"address_2": "STE 103",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852245225",
"telephone_number": "480-821-1997",
"fax_number": "480-821-1887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1076 W CHANDLER BLVD",
"address_2": "STE 103",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852245225",
"telephone_number": "480-821-1997",
"fax_number": "480-821-1887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ",
"first_name": "FABIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2012-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "7454",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "21223",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.