Individual provider Active NPI

Jessica Brooke Chaves, P.T.

  • Physical Therapist
  • Tiverton, RI
National Provider Identifier
1407056799
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT01579 Issued in RI
Practice address
31 Shove St
Tiverton, RI 02878-1029
Phone
(401) 624-4743
Fax
(401) 624-9152
NPI assigned
Jul 24, 2007
Last updated
Jul 24, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT01579 RI Primary

Addresses

Primary practice location

31 Shove St
Tiverton, RI 02878-1029

Mailing address

31 Shove St
Tiverton, RI 02878-1029
Phone (401) 624-4743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020000024 RI Practitioner - Physical Therapist in Private Practice 2062473473 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT01579RIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sakonnet Physical Therapy, Inc Physical Therapist CurrentSince Feb 8, 2015 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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185235200000",
    "number": "1407056799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 SHOVE ST",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028781029",
            "telephone_number": "401-624-4743",
            "fax_number": "401-624-9152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 SHOVE ST",
            "city": "TIVERTON",
            "state": "RI",
            "postal_code": "028781029",
            "telephone_number": "401-624-4743",
            "fax_number": "401-624-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVES",
        "first_name": "JESSICA",
        "middle_name": "BROOKE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT01579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tiverton, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; 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.