Individual provider Active NPI

Charles Edgar Chapman, CMT

  • Massage Therapist
  • Fort Wayne, IN
National Provider Identifier
1649512021
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MT20900595 Issued in IN
Practice address
5421 Kroemer Rd
Fort Wayne, IN 46818-9327
Phone
(260) 497-0629
NPI assigned
Mar 22, 2013
Last updated
Mar 22, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MT20900595 IN Primary

Addresses

Primary practice location

5421 Kroemer Rd
Fort Wayne, IN 46818-9327

Mailing address

5421 Kroemer Rd
Fort Wayne, IN 46818-9327
Phone (260) 497-0629

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
MT20900595INMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363910400000",
    "number": "1649512021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5421 KROEMER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468189327",
            "telephone_number": "260-497-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5421 KROEMER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468189327",
            "telephone_number": "260-497-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN",
        "first_name": "CHARLES",
        "middle_name": "EDGAR",
        "name_prefix": "Mr.",
        "credential": "CMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-22",
        "last_updated": "2013-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IN",
            "license": "MT20900595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.