Individual provider Active NPI

Christopher Ryan Chance

  • Physical Therapist
  • Southport, NC
National Provider Identifier
1639559289
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P15570 Issued in NC
Practice address
4002 Executive Park Blvd Ste 800
Southport, NC 28461-9069
Phone
(910) 477-6326
NPI assigned
Jun 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7799 SC
Physical Therapist 225100000X P15570 NC Primary

Addresses

Primary practice location

4002 Executive Park Blvd Ste 800
Southport, NC 28461-9069

Mailing address

625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395
Phone (616) 356-5000

Other practice location 1

704 N Judd Pkwy NE
Ste 100
Fuquay Varina, NC 27526-7394
Phone (919) 896-7158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160519001400 NC Practitioner - Physical Therapist in Private Practice 6800101452 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Performance Sports and Physical Therapy LLCGroup PAC ID 0749276426, 60 clinicians

Practice addresses (Care Compare)

8504 Darton Way
Suite 105
Raleigh, NC 27616-9315
Phone (929) 207-1208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7799SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Strong Physical Therapy, LLC Physical Therapist CurrentSince Oct 14, 2024 Accepting new patients
Benchmark Physical Therapy of North Carolina LLC Physical Therapist CurrentSince Aug 30, 2021 Accepting new patients
Peak Performance Sports and Physical Therapy, LLC Physical Therapist CurrentSince Oct 27, 2024 Accepting new patients
Benchmark Physical Therapy of NC, LLC Physical Therapist CurrentSince Aug 30, 2021 Accepting new patients
Elite Integrated Therapy Centers, LLC Physical Therapist CurrentSince Nov 1, 2021 Accepting new patients
Activcare Physical Therapy, LLC Physical Therapist CurrentSince Aug 8, 2016 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

625 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546

3100 NC 55 Hwy
Ste 101
Cary, NC 27519
Phone (919) 290-2799

166 Springbrook Ave
Ste 201
Clayton, NC 27520
Phone (919) 535-8461

704 N Judd Pkwy NE
Ste 100
Fuquay Varina, NC 27526
Phone (919) 896-7158

10020 Monroe Rd
Ste 160
Matthews, NC 28105
Phone (704) 841-0894

2009 Neuse Blvd
New Bern, NC 28560
Phone (252) 636-9800

3410 Executive Dr
Ste 205
Raleigh, NC 27609
Phone (919) 322-0042

8504 Darton Way
Ste 105
Raleigh, NC 27616
Phone (929) 207-1208

292 Commerce Ave
Southern Pnes, NC 28387
Phone (910) 757-0408

4002 Executive Park Blvd
Ste 800
Southport, NC 28461
Phone (910) 357-5748

4355 NC Highway 211
#D
West End, NC 27376
Phone (910) 310-4850

5619 Carolina Beach Rd
Ste 120
Wilmington, NC 28412
Phone (910) 790-1976

140 Executive Dr
Greer, SC 29651
Phone (864) 801-8706

719 SE Main St
#B
Simpsonville, SC 29681
Phone (864) 522-5400

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1639559289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395",
            "telephone_number": "616-356-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 EXECUTIVE PARK BLVD STE 800",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284619069",
            "telephone_number": "910-477-6326"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 N Judd Pkwy NE",
            "address_2": "Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fuquay Varina",
            "state": "NC",
            "postal_code": "275267394",
            "country_code": "US",
            "telephone_number": "919-896-7158",
            "fax_number": "919-896-7208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANCE",
        "first_name": "CHRISTOPHER",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7799",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P15570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.