Douglas Kendrick Chan, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305006554 Issued in VA

Practice address

3767 Fettler Park Drive
Dumfries, VA 22025

Phone

(703) 730-6400

NPI assigned

Nov 16, 2006

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 VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Physical Therapy LLCGroup PAC ID 4183948011, 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.

• Professional Physical Therapy LLC

  • Physical Therapist
  • Dumfries, VA
  • NPI 1114321619
  Medicare reassignment Care Compare group NPD Authorized official
• Lake Ridge Physical Therapy, LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1871598417
  NPD (past)

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1376616268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4328 TARPON LN",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223093135",
            "telephone_number": "703-780-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3767 FETTLER PARK DRIVE",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "22025",
            "telephone_number": "703-730-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "DOUGLAS",
        "middle_name": "KENDRICK",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305006554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary E Campise
• Carrington Developmental Support Services LLC
• Kimberly Carter, PSY.D.
• Certified Skilled Nursing Service & Associates
• Zerline E Chambers, M.D.
• Esther Chatman, FAM NUR PRACTITIONER
• Rameen Chaudhry, RBT
• Alexandra Nicole Chavez, PT, DPT
• Yuskiran Kaur Chhabra, VA
• Children First, Inc

• Physical Therapist in Dumfries, VA
• Providers in Dumfries, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.