Individual provider Active NPI

Christopher Velasco

  • Physical Therapist
  • Chattanooga, TN
National Provider Identifier
1144927203
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14789 Issued in TN
Practice address
2158 Northgate Park LN Unit 200
Chattanooga, TN 37415-6911
Phone
(423) 254-5461
NPI assigned
Feb 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 14789 TN Primary

Addresses

Primary practice location

2158 Northgate Park LN Unit 200
Chattanooga, TN 37415-6911

Mailing address

625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395

Other practice location 1

313 Manufacturers Rd Unit C215
Chattanooga, TN 37405-3274
Phone (423) 254-5461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230315003189 TN Practitioner - Physical Therapist in Private Practice 9032583935 Reassigns benefits to 1 organization
I20250114000531 GA Practitioner - Physical Therapist in Private Practice 9032583935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Rehabilitation and SportsGroup PAC ID 1759481559, 53 clinicians

Practice addresses (Care Compare)

313 Manufacturers Rd
Suite C215
Chattanooga, TN 37405-3274
Phone (423) 254-5461

3460 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4007
Phone (706) 719-2253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Rehabilitation and Sports Physical Therapist CurrentSince Feb 13, 2023 Accepting new patients
Excel Rehabilitation and Sports Physical Therapist CurrentSince Feb 13, 2023 Accepting new patients

Locations

3460 Battlefield Pkwy
Ft Oglethorpe, GA 30742
Phone (706) 719-2253

625 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546

2158 Northgate Park Ln
Ste 200
Chattanooga, TN 37415
Phone (423) 254-5461

313 Manufacturers Rd
Ste C215
Chattanooga, TN 37405
Phone (423) 254-5461

7443 Commons Blvd
Ste 112
Chattanooga, TN 37421
Phone (423) 254-5461

1700 Broad St
Ste 120
Chattanooga, TN 37408
Phone (423) 254-5461

862 Callen Ln NW
Ste 100
Cleveland, TN 37312
Phone (423) 254-5461

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.

NPI Registry JSON

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1144927203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 NORTHGATE PARK LN UNIT 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374156911",
            "telephone_number": "423-254-5461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "313 Manufacturers Rd Unit C215",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374053274",
            "country_code": "US",
            "telephone_number": "423-254-5461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; 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.