Madisyn Chavez, LAT, ATC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

2000035929 Issued in CA

Practice address

5500 Campanile Dr
San Diego, CA 92182-0001

Phone

(619) 594-7651

NPI assigned

Jan 28, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1821689282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 CAMPANILE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921820001",
            "telephone_number": "619-594-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 CAMPANILE DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921820001",
            "telephone_number": "619-594-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVEZ",
        "first_name": "MADISYN",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "CA",
            "license": "2000035929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrchavez@sdsu.edu",
            "affiliation": "Y",
            "endpointDescription": "email address",
            "affiliationName": "San Diego State University",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5500 Campanile Dr",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921820001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Leeniese Chavez, SFIDC
• Laura Chavez, ASW
• Laura Lizette Chavez, BCBA
• Luis Omar Chavez, MD
• Lupita Chavez
• Marco Antonio Chavez, M.D.
• Miguel De Jesus Chavez
• Monica Nicole Chavez
• Nebai Chavez
• Pricilla Chavez

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in California

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

Verify at the official NPI Registry.