Active NPI
Nancy Susan Chennell, PT
- Physical Therapist
- Vista, CA
National Provider Identifier
1679695217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 00008672
- Practice address
- 1830 Hacienda Dr
Suite 2
Vista, CA 92081-4544 - Phone
- (760) 941-8600
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 00008672 | CA | Primary |
Addresses
Primary practice location
1830 Hacienda Dr
Suite 2
Vista, CA 92081-4544
Mailing address
1830 Hacienda Dr
Suite 2
Vista, CA 92081-4544
Phone (760) 941-8600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT0086272 | Other | CA | PT LIS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00008672 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223251200000",
"number": "1679695217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1830 HACIENDA DR",
"address_2": "SUITE 2",
"city": "VISTA",
"state": "CA",
"postal_code": "920814544",
"telephone_number": "760-941-8600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 HACIENDA DR",
"address_2": "SUITE 2",
"city": "VISTA",
"state": "CA",
"postal_code": "920814544",
"telephone_number": "760-941-8600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHENNELL",
"first_name": "NANCY",
"middle_name": "SUSAN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2008-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "00008672",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LIS",
"identifier": "PT0086272",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.