Active NPI
Heather Renee' Chavez, COTA/L
- Occupational Therapy Assistant
- Surprise, AZ
National Provider Identifier
1447830617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 5617
- Practice address
- 15453 W Ventura St
Surprise, AZ 85379-8026 - Phone
- (623) 261-2730
- NPI assigned
- Apr 12, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5617 | AZ | Primary |
Addresses
Primary practice location
15453 W Ventura St
Surprise, AZ 85379-8026
Mailing address
15453 W Ventura St
Surprise, AZ 85379-8026
Phone (623) 261-2730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5617 | AZ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618185600000",
"number": "1447830617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15453 W VENTURA ST",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853798026",
"telephone_number": "623-261-2730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15453 W VENTURA ST",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853798026",
"telephone_number": "623-261-2730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVEZ",
"first_name": "HEATHER",
"middle_name": "RENEE'",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-12",
"last_updated": "2021-04-12",
"certification_date": "2021-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AZ",
"license": "5617",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.