Individual provider Active NPI

Hennessey Hiileionalani Ellis Chan, PT, DPT

  • Rehabilitation Practitioner
  • Addison, TX
National Provider Identifier
1336055540
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
1408903 Issued in TX
Practice address
15810 Midway Rd
Addison, TX 75001-4259
Phone
(972) 458-8111
NPI assigned
Aug 19, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X 1408903 TX Primary

Addresses

Primary practice location

15810 Midway Rd
Addison, TX 75001-4259

Mailing address

6315 Campbell Rd Apt 108
Dallas, TX 75248-1399
Phone (808) 726-0657

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1336055540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6315 CAMPBELL RD APT 108",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481399",
            "telephone_number": "808-726-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15810 MIDWAY RD",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014259",
            "telephone_number": "972-458-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "HENNESSEY",
        "middle_name": "HIILEIONALANI ELLIS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "TX",
            "license": "1408903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.