John Austin Wren Chellis, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501016126 Issued in MI

Practice address

812 S Garfield Ave
Traverse City, MI 49686-3456

Phone

(231) 421-9201

Fax

(231) 421-9193

NPI assigned

Dec 20, 2012

Sex

Male

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

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Therapy Group LLCGroup PAC ID 6901178060, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Advanced Therapy Group, LLC

  • Physical Therapist
  • Traverse City, MI
  • NPI 1326391137
  Medicare reassignment Care Compare group NPD
• Kingsley Physical Therapy, P.L.L.C.

  dba Kingsley Physical Therapy

  • Physical Therapy Clinic/Center
  • Kingsley, MI
  • NPI 1871549857

  Physical Therapist

  NPD
• Speech for All Seasons

  • Hearing and Speech Clinic/Center
  • Traverse City, MI
  • NPI 1790420693
  NPD

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215273297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 S GARFIELD AVE STE 1",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863456",
            "telephone_number": "231-421-9201",
            "fax_number": "231-421-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S GARFIELD AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863456",
            "telephone_number": "231-421-9201",
            "fax_number": "231-421-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHELLIS",
        "first_name": "JOHN",
        "middle_name": "AUSTIN WREN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-20",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Chargo
• Charity Manke, Ma, LLP
• Elisabeth Charles
• Destyne L Chavalia
• Natalya Chegudi, M.S.
• Cherry Bay Dental
• Cherry Bend Family Care, PLC
• Cherry Capital Cab LLC
• Cherry Hill Haven Inc.
• Cherryland Chiropractic Centre PC

• Physical Therapist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.