Maisie Violet Chin, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2598 Issued in GA

Practice address

5810 Wyndemere LN
Stone Mountain, GA 30087-2529

Phone

(770) 564-3322

NPI assigned

Jul 20, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sovereign Rehabilitation of Georgia, LLC

  • Physical Therapy Clinic/Center
  • Decatur, GA
  • NPI 1326210840
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962422196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 WYNDEMERE LN",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872529",
            "telephone_number": "770-564-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 WYNDEMERE LN",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300872529",
            "telephone_number": "770-564-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIN",
        "first_name": "MAISIE",
        "middle_name": "VIOLET",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "2598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Children and Teen Dental Group
• Children First Quality Service
• Childrens Dentistry of Lithonia LLC
• Gwendolyn J Childs, M.A., PSY.D.
• Beverley Hyacinth Chin
• Hyung Wook Choi, PHARM D
• Godwin Chukudi
• Eleanor Chung, LPN
• Sasha-Ann L Cisneros
• Ashley Victoria Clark, PTA

• Physical Therapist in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.