Jesse Chase, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA004639 Issued in GA

Practice address

1404 Lawrenceville Suwanee Rd # A102
Lawrenceville, GA 30043-4331

Phone

(678) 749-0912

NPI assigned

Sep 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1750005211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 TRIP ST",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300177860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 LAWRENCEVILLE SUWANEE RD # A102",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434331",
            "telephone_number": "678-749-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHASE",
        "first_name": "JESSE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA004639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Y. Chang, M.D.
• Donald Chapman, D.O
• Rukshar Charania, RN
• Charles B Moomey Jr MD
• Andrea Marie Charnock, CAA
• Chasing Balanced Wellness, LLC
• Crystal Lynn Chastain, CNP
• Lauren Nicole Chatham, M.D.
• Dinesh K. Chatoth, M.D.
• Chattahoochee Home Oxygen Service, Inc

• Physical Therapy Assistant in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Physical Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.