Active NPI
Chad Van Horn, PA-C
- Physician Assistant
- Davie, FL
National Provider Identifier
1154866952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PAT9110097
- Practice address
- 1970 S University Dr Ste 25&26
Davie, FL 33324-5846 - Phone
- (954) 864-4100
- NPI assigned
- Jan 3, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAT9110097 | FL | Primary |
Addresses
Primary practice location
1970 S University Dr Ste 25&26
Davie, FL 33324-5846
Mailing address
1970 S University Dr Ste 25&26
Davie, FL 33324-5846
Phone (954) 864-4100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAT9110097 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646265600000",
"number": "1154866952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1970 S UNIVERSITY DR STE 25&26",
"city": "DAVIE",
"state": "FL",
"postal_code": "333245846",
"telephone_number": "954-864-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1970 S UNIVERSITY DR STE 25&26",
"city": "DAVIE",
"state": "FL",
"postal_code": "333245846",
"telephone_number": "954-864-4100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN HORN",
"first_name": "CHAD",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-03",
"last_updated": "2022-03-03",
"certification_date": "2022-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PAT9110097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.