Ergo Body Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

19701 Issued in FL

Legal business name

ERGO BODY INC.

Doing business as

Ergo Body

Practice address

1555 San Marco Blvd
Jacksonville, FL 32207-2905

Phone

(904) 536-1829

Fax

(904) 396-1787

NPI assigned

Oct 7, 2014

Last updated

Oct 7, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ilene M Chazan, PT

Title

President, Physical Therapist

Phone

(904) 536-1829

Specialties & licenses 1

Addresses

Other names 1

• Ergo Body Doing business as

Locations

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1609279405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3655 SAN JOSE BLVD.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075224",
            "telephone_number": "904-536-1829",
            "fax_number": "904-396-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SAN MARCO BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072905",
            "telephone_number": "904-536-1829",
            "fax_number": "904-396-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERGO BODY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "CHAZAN",
        "authorized_official_first_name": "ILENE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "904-536-1829",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "19701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ergo Body",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Young Mi Erben, M.D.
• Jean E Erdal, PT
• Michael Joseph Erdman, PHARMD
• Elisa Ereckson, APRN
• Christina Joelene Erford, DNP, APRN, NP-C
• Michael J. Erhard, MD
• Eric M. Gabriel, M.D., P.a.
• Eric W Shultz DPM PA
• Ericka Ericka Vargas
• Alexander Christian Erickson, IDC

• Physical Therapy Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.