Individual provider Active NPI

Keith E Chagaris, ATC, PTA, CSCS

  • Athletic Trainer
  • Centerville, MA
National Provider Identifier
1124243712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
625 Issued in MA
Practice address
9 Kay Ave
Centerville, MA 02632-3621
Phone
(508) 862-0253
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 625 MA Primary

Addresses

Primary practice location

9 Kay Ave
Centerville, MA 02632-3621

Mailing address

9 Kay Ave
Centerville, MA 02632-3621
Phone (508) 862-0253

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
625MAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124243712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 KAY AVE",
            "city": "CENTERVILLE",
            "state": "MA",
            "postal_code": "026323621",
            "telephone_number": "508-862-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 KAY AVE",
            "city": "CENTERVILLE",
            "state": "MA",
            "postal_code": "026323621",
            "telephone_number": "508-862-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAGARIS",
        "first_name": "KEITH",
        "middle_name": "E",
        "credential": "ATC, PTA, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.