Active NPI
Chaney Elizabeth Black, D.P.T.
- Physical Therapist
- Fayetteville, AR
National Provider Identifier
1326486143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT3510
- Practice address
- 3061 Market
Suite 4
Fayetteville, AR 72703 - Phone
- (479) 444-6277
- Fax
- (479) 444-6278
- NPI assigned
- Jun 14, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT3510 | AR | Primary |
Addresses
Primary practice location
3061 Market
Suite 4
Fayetteville, AR 72703
Mailing address
PO Box 871
Tontitown, AR 72770-0871
Phone (479) 751-3900
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT3510 | AR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371168000000",
"number": "1326486143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 871",
"city": "TONTITOWN",
"state": "AR",
"postal_code": "727700871",
"telephone_number": "479-751-3900",
"fax_number": "479-751-3011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3061 MARKET",
"address_2": "SUITE 4",
"city": "FAYETTEVILLE",
"state": "AR",
"postal_code": "72703",
"telephone_number": "479-444-6277",
"fax_number": "479-444-6278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "CHANEY",
"middle_name": "ELIZABETH",
"credential": "D.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-14",
"last_updated": "2013-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "PT3510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.