Individual provider Active NPI

Chances Amelia Waite, PT, DPT

  • Physical Therapist
  • Hixson, TN
National Provider Identifier
1134610520
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12675 Issued in TN
Practice address
5022 Old Godsey LN Ste 3
Hixson, TN 37343-6604
Phone
(423) 870-3573
Fax
(423) 870-3574
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT013437 GA
Physical Therapist 225100000X 12675 TN Primary

Addresses

Primary practice location

5022 Old Godsey LN Ste 3
Hixson, TN 37343-6604

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-8907

Other practice location 1

1615 State Highway 17 Ste 9
Young Harris, GA 30582
Phone (706) 896-2771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180827000957 GA Practitioner - Physical Therapist in Private Practice 2567711435 Reassigns benefits to 1 organization
I20200124002090 TN Practitioner - Physical Therapist in Private Practice 2567711435 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

5022 Old Godsey LN
Suite 3
Hixson, TN 37343-6604
Phone (423) 870-3573

5220 Park Ave
Suite 201
Memphis, TN 38119-3549
Phone (901) 683-9630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT013437GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA, Inc Physical Therapist CurrentSince Jan 9, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jun 14, 2018 Accepting new patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Jan 1, 2020 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist Current Accepting new patients
Independent Physical Therapy of Ga, LLC Physical Therapist CurrentSince Jun 14, 2018 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Jan 9, 2024 Accepting new patients
Independent Physical Therapy Physical Therapist CurrentSince Jan 1, 2020 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

1615 State Highway 17
Ste 9
Young Harris, GA 30582
Phone (706) 896-2771

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

2177 Northpoint Blvd
Ste 101
Hixson, TN 37343
Phone (423) 870-1289

5022 Old Godsey Ln
Ste 3
Hixson, TN 37343
Phone (423) 870-3573

5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1134610520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-8907",
            "fax_number": "423-362-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5022 OLD GODSEY LN STE 3",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373436604",
            "telephone_number": "423-870-3573",
            "fax_number": "423-870-3574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1615 State Highway 17 Ste 9",
            "address_purpose": "LOCATION",
            "city": "Young Harris",
            "state": "GA",
            "postal_code": "30582",
            "country_code": "US",
            "telephone_number": "706-896-2771",
            "fax_number": "706-896-2772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAITE",
        "first_name": "CHANCES",
        "middle_name": "AMELIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013437",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "12675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.

Verify at the official NPI Registry.