Kimberlly Chawntae Chavez, PTA, CLT

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2148253 Issued in TX

Practice address

3875 E Southcross Blvd Ste a
San Antonio, TX 78222-3521

Phone

(210) 337-7953

Fax

(210) 337-7966

NPI assigned

Dec 27, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberlly Chawntae Cepeda Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1703635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1346019734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3875 E SOUTHCROSS BLVD STE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782223521",
            "telephone_number": "210-763-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3875 E SOUTHCROSS BLVD STE A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782223521",
            "telephone_number": "210-337-7953",
            "fax_number": "210-337-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "KIMBERLLY",
        "middle_name": "CHAWNTAE",
        "credential": "PTA, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-27",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2148253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLLY",
            "last_name": "CEPEDA",
            "middle_name": "CHAWNTAE",
            "credential": "PTA, CLT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joana Karina Chavez, AGACNP
• Jorge A Chavez, M.D.
• Joshua R Chavez
• Justin Michael Chavez, M.S., CCC-SLP
• Justine Chavez
• Kimberly Chavez
• Lauryn Chavez
• Lianna Chavez
• Lisa Marie Chavez
• Maria Alondra Chavez

• Physical Therapy Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.