Active NPI
Alexis Chacon
- Physician Assistant
- Kissimmee, FL
National Provider Identifier
1982392940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1600-P.A
- Practice address
- 2301 Santa Lucia St
Kissimmee, FL 34743-3339 - Phone
- (786) 730-0035
- NPI assigned
- Apr 27, 2023
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1600-P.A | PR | Primary |
Addresses
Primary practice location
2301 Santa Lucia St
Kissimmee, FL 34743-3339
Mailing address
2301 Santa Lucia St
Kissimmee, FL 34743-3339
Phone (786) 730-0035
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 |
|---|---|---|---|
| 1600-P.A | PR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682553600000",
"number": "1982392940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2301 SANTA LUCIA ST",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347433339",
"telephone_number": "786-730-0035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 SANTA LUCIA ST",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347433339",
"telephone_number": "786-730-0035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHACON",
"first_name": "ALEXIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-27",
"last_updated": "2023-04-27",
"certification_date": "2023-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "1600-P.A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.