Individual provider Active NPI

Chad Scott Mehl

  • Physical Therapy Assistant
  • Fort Myers, FL
National Provider Identifier
1477081552
Registry record updated Jun 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA19111 Issued in FL
Practice address
3735 Evans Ave
Fort Myers, FL 33901-9302
Phone
(237) 277-3977
NPI assigned
Jun 1, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225200000X PTA19111 FL Primary

Addresses

Primary practice location

3735 Evans Ave
Fort Myers, FL 33901-9302

Mailing address

3735 Evans Ave
Fort Myers, FL 33901-9302

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

LicenseStateTypeSpecialty
PTA19111FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496275200000",
    "number": "1477081552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3735 EVANS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3735 EVANS AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019302",
            "telephone_number": "237-277-3977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHL",
        "first_name": "CHAD",
        "middle_name": "SCOTT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-01",
        "last_updated": "2017-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA19111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2017; 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.