Individual provider Active NPI

George Daniel Chandler Jr., PTA

  • Physical Therapy Assistant
  • Garner, NC
National Provider Identifier
1649949355
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A6345 Issued in NC
Practice address
1325 Timber Dr E
Garner, NC 27529-6924
Phone
(919) 781-4060
Fax
(919) 781-5246
NPI assigned
Sep 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A6345 NC Primary

Addresses

Primary practice location

1325 Timber Dr E
Garner, NC 27529-6924

Mailing address

2048 Queen Charlotte PL
Raleigh, NC 27610-9636
Phone (336) 689-4935

Other practice location 1

4030 Cardinal At North Hills St
Raleigh, NC 27609-2616
Phone (984) 204-8444

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
A6345NCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1649949355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2048 QUEEN CHARLOTTE PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276109636",
            "telephone_number": "336-689-4935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 TIMBER DR E",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275296924",
            "telephone_number": "919-781-4060",
            "fax_number": "919-781-5246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4030 Cardinal At North Hills St",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276092616",
            "country_code": "US",
            "telephone_number": "984-204-8444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANDLER",
        "first_name": "GEORGE",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-07",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A6345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garner, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.