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NPI Code Detail

MEDICARE: CARRIE L CHAMBERLAIN PT, DPT

MEDICARE: CARRIE L CHAMBERLAIN PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist2305204388VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00608798OTHERVARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3192946OTHERVABCBS (PHYSICAL THERAPY)
49261158OTHERVAAETNA

General Provider Information

NPI Number : 1316114796
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE L CHAMBERLAIN PT, DPT
Provider Business Mailing Address
First Line : 771 PILOT HOUSE DR
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23606-1990
Country : US
Telephone Number : 757-873-2302
Fax Number : 757-873-2306
Provider Business Practice Location Address
First Line : 300B TEMPLE LAKE DR
Second Line : SUITE 1
City : COLONIAL HEIGHTS
State : VA
Zip : 23834-2973
Country : US
Telephone Number : 804-524-9036
Fax Number : 804-524-9039
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2008
Last Update Date : 01/16/2011

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