Jeremy Dalisay Chan

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA21191 Issued in FL

Practice address

6798 Ashburn Rd
Lake Worth, FL 33467-7319

Phone

(561) 603-5389

NPI assigned

Apr 4, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1346413804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6798 ASHBURN RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6798 ASHBURN RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334677319",
            "telephone_number": "561-603-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "JEREMY",
        "middle_name": "DALISAY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-04",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA21191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mirianne Cetoute
• Stephanie Nicholle Cevallos
• Cfsatc Inc (Central Florida Treatment Center Lake Worth)
• Donald Chamberlin, LMHC
• Janhoi T Chambers, CSFA
• Chandler Health Systems LLC
• Change & Growth Therapy Center
• Carmen Yaneth Chantre
• Laura Chapman, CRS,CDDC,CACII,CNDAI
• Jacqueline Charbonneau

• Physical Therapy Assistant in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; 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.