Active NPI
Justine Chan
- Pediatric Occupational Therapist
- Virginia Beach, VA
National Provider Identifier
1992239438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 011-007268
- Practice address
- 1400 Fordham Dr
Virginia Beach, VA 23464-5368 - Phone
- (757) 361-3951
- NPI assigned
- Apr 11, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 011-007268 | VA | Primary |
Addresses
Primary practice location
1400 Fordham Dr
Virginia Beach, VA 23464-5368
Mailing address
330 Greens Edge Dr
Chesapeake, VA 23322-8078
Phone (757) 618-8111
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 |
|---|---|---|---|
| 011-007268 | VA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491868800000",
"number": "1992239438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 GREENS EDGE DR",
"city": "CHESAPEAKE",
"state": "VA",
"postal_code": "233228078",
"telephone_number": "757-618-8111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 FORDHAM DR",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234645368",
"telephone_number": "757-361-3951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAN",
"first_name": "JUSTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-11",
"last_updated": "2017-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "VA",
"license": "011-007268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.