Kyle Michael Chamness, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.005944 Issued in IL

Practice address

374 E Grand Ave
Carbondale, IL 62901-3962

Phone

(618) 453-1292

Fax

(618) 453-4290

NPI assigned

Mar 11, 2013

Last updated

Mar 11, 2013By the provider in NPPES

Sex

Male

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": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1871834200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "HURST",
            "state": "IL",
            "postal_code": "629490125",
            "telephone_number": "618-201-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 E GRAND AVE",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013962",
            "telephone_number": "618-453-1292",
            "fax_number": "618-453-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMNESS",
        "first_name": "KYLE",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-11",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.005944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Cerney, ATC
• Thomas Norbert Cerny, R.PH.
• CFC 24 Archway, Inc
• Stephanie Marie Chambers-Baltz, PHD, LP
• Jenifer Marie Chambless, PA-C
• Laura E Chandler, MS/CCC-SLP
• Rakesh Chandra, MD
• Dongwoo John Chang, M.D.
• Hark Chang, M.D.
• Radhika Chang, MD

• Physical Therapy Assistant in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; 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.