Active NPI
Brad Chavis, ATC
- Athletic Trainer
- Tempe, AZ
National Provider Identifier
1508059908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 704
- Practice address
- 1025 E Broadway Rd
Ste. 100
Tempe, AZ 85282-1599 - Phone
- (480) 829-0217
- Fax
- (480) 829-1410
- NPI assigned
- Aug 20, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 704 | AZ | Primary |
Addresses
Primary practice location
1025 E Broadway Rd
Ste. 100
Tempe, AZ 85282-1599
Mailing address
1025 E Broadway Rd
Ste. 100
Tempe, AZ 85282-1599
Phone (480) 829-0217
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 |
|---|---|---|---|
| 704 | AZ | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BHSM Rehabilitation, LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Payson, AZ
- NPI 1497222632
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187568000000",
"number": "1508059908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 E BROADWAY RD",
"address_2": "STE. 100",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852821599",
"telephone_number": "480-829-0217",
"fax_number": "480-829-1410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 E BROADWAY RD",
"address_2": "STE. 100",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852821599",
"telephone_number": "480-829-0217",
"fax_number": "480-829-1410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAVIS",
"first_name": "BRAD",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-20",
"last_updated": "2007-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.