Active NPI
Melissa Kehaulani Inouye Glass, PT
- Physical Therapist
- Emeryville, CA
National Provider Identifier
1477576338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 28070
- Practice address
- 2322 Powell Street
Emeryville Sports Physical Therapy
Emeryville, CA 94608-1963 - Phone
- (510) 653-5151
- NPI assigned
- Jul 25, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 28070 | CA | Primary |
Addresses
Primary practice location
2322 Powell Street
Emeryville Sports Physical Therapy
Emeryville, CA 94608-1963
Mailing address
2322 Powell Street
Emeryville Sports Physical Therapy
Emeryville, CA 94608
Phone (510) 653-5151
Other names 1
- Melissa Kehaulani Chan
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477576338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2322 POWELL STREET",
"address_2": "EMERYVILLE SPORTS PHYSICAL THERAPY",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "94608",
"telephone_number": "510-653-5151",
"fax_number": "510-601-1358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2322 POWELL STREET",
"address_2": "EMERYVILLE SPORTS PHYSICAL THERAPY",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081963",
"telephone_number": "510-653-5151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLASS",
"first_name": "MELISSA",
"middle_name": "KEHAULANI INOUYE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "28070",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "CHAN",
"middle_name": "KEHAULANI",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Emeryville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.