Individual provider Active NPI

Remmie Edward Chacon, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1669651014
Registry record updated May 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7857 Issued in AZ
Practice address
300 W Clarendon Ave
Suite 285
Phoenix, AZ 85013-3420
Phone
(602) 277-3686
Fax
(602) 277-3676
NPI assigned
Nov 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7857 AZ Primary

Addresses

Primary practice location

300 W Clarendon Ave
Suite 285
Phoenix, AZ 85013-3420

Mailing address

300 W Clarendon Ave
Suite 285
Phoenix, AZ 85013-3420
Phone (602) 277-3686

Other identifiers 2

IdentifierTypeStateIssuer
Z113264OtherAZMEDICARE GROUP
286449MedicaidAZ

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1669651014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE",
            "address_2": "SUITE 285",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133420",
            "telephone_number": "602-277-3686",
            "fax_number": "602-277-3676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE",
            "address_2": "SUITE 285",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133420",
            "telephone_number": "602-277-3686",
            "fax_number": "602-277-3676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHACON",
        "first_name": "REMMIE",
        "middle_name": "EDWARD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-01",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "7857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "Z113264",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286449",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.