Crystal A Champion, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT008962 Issued in GA

Practice address

3742 Greenwich Ave
Duluth, GA 30096-6334

Phone

(706) 631-1030

NPI assigned

Feb 6, 2007

Sex

Female

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)

Enrolled

State licenses

Practice roles

Locations

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.

• Neuropathy Wellness Specialists, LLC

  • General Practice Physician
  • Dacula, GA
  • NPI 1215279294
  NPD

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598745600000",
    "number": "1124167739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3742 GREENWICH AVE",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300966334",
            "telephone_number": "706-631-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3742 GREENWICH AVE",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300966334",
            "telephone_number": "706-631-1030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPION",
        "first_name": "CRYSTAL",
        "middle_name": "A",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-30",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Qing Chai, M.D.
• Chalice Healthcare Services, LLC
• Vanessa Chambers, LPC
• Cenir Chamblee
• Dianna Champ
• Elaine Yiting Chan, PHARMD
• Jing Chan
• Mukta Chandora, M.D.
• Courtney Chaney
• Jennifer Mayfield Chaney, M. ED

• Physical Therapist in Duluth, GA
• Providers in Duluth, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2020; 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.