Active NPI
Brett Chandler, PT,DPT
- Physical Therapist
- St Augustine, FL
National Provider Identifier
1790114809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT27739
- Practice address
- 105 E Pine Hollow TRL Unit 208
Saint Augustine, FL 32086-7670 - Phone
- (931) 237-2058
- NPI assigned
- Nov 8, 2013
- Last updated
- Sep 23, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | PT27739 | FL | Primary |
Addresses
Primary practice location
105 E Pine Hollow TRL Unit 208
Saint Augustine, FL 32086-7670
Mailing address
222 S Coopers Hawk Way
Palm Coast, FL 32164-2328
Phone (931) 237-2058
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT27739 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632355200000",
"number": "1790114809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 S COOPERS HAWK WAY",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321642328",
"telephone_number": "931-237-2058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 E PINE HOLLOW TRL UNIT 208",
"city": "SAINT AUGUSTINE",
"state": "FL",
"postal_code": "320867670",
"telephone_number": "931-237-2058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANDLER",
"first_name": "BRETT",
"credential": "PT,DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-11-08",
"last_updated": "2021-09-23",
"certification_date": "2021-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT27739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
- Center for Psychological Services Inc
- Center for Relational Psychotherapy
- Certified Medical Systems III Inc
- Cindy O Chaconas, DPT, ATC
- Eric James Chaconas, DPT
- Heather Nicole Chandler
- Jessica Lynn Chandler
- Lauren Chane, LCSW
- Changing Tides Chiropractic & Wellness, LLC.
- Changing Tides Chiropractic and Wellness LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.