Healthcare Provider Details

I. General information

NPI: 1053390666
Provider Name (Legal Business Name): VIRGIN ISLAND ORTHOPEDICS AND SPORTS MEDICINE P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 ESTATE THOMAS PARAGON MEDICAL BUILDING SUITE 104
ST THOMAS VI
00802-2615
US

IV. Provider business mailing address

PO BOX 8360
ST THOMAS VI
00801-1360
US

V. Phone/Fax

Practice location:
  • Phone: 340-714-2845
  • Fax:
Mailing address:
  • Phone: 340-714-2845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number1122
License Number StateVI
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number2509
License Number StateVI
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number131
License Number StateVI
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number068
License Number StateVI

VIII. Authorized Official

Name: DR. JEFFREY M CHASE
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 340-714-2845