Jessica Brooke Chaves, P.T.
Individual provider Active NPI Physical Therapist · Tiverton, RI
NPI 1407056799 · NPPES record last updated Jul 24, 2007
Key facts
- NPI
- 1407056799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT01579 (RI)
- Practice address
- 31 Shove St
Tiverton, RI 02878-1029 - Phone
- (401) 624-4743
- Fax
- (401) 624-9152
- NPI assigned
- Jul 24, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1220 Fish Rd
Suite 1
Tiverton, RI 02878-3130
Phone (401) 624-4743
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041020000024 | RI | Practitioner - Physical Therapist in Private Practice | 2062473473 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT01579 | RI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sakonnet Physical Therapy, Inc | Physical Therapist | Current |
Accepting new patients |
Locations
1220 Fish Rd
Ste 1
Tiverton, RI 02878
Phone (401) 624-4743
31 Shove St
Tiverton, RI 02878
Phone (401) 624-4743
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT01579 | RI | Yes |
Addresses
Primary practice location
31 Shove St
Tiverton, RI 02878-1029
Mailing address
31 Shove St
Tiverton, RI 02878-1029
Phone (401) 624-4743
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23335-8 | Other | BLUE CROSS BLUE SHIELD |
Other providers in Tiverton, RI
- Stephanie Carlile
- Rachael Christine Cavallaro
- Louis Anthony Cerbo
- Virginia M Cerbo
- Sara Elizabeth Charnecki
- Justin M Costa
- Norman A Cote
- Melissa Cotta
- Adam J Cox
- Tracy Ann Dagesse
All providers in Tiverton, RI · Physical Therapist in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.