Provider Demographics
NPI:1962697789
Name:CHIPMAN, STEVEN THOMAS (PT)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:THOMAS
Last Name:CHIPMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6077 PRIMACY PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5742
Mailing Address - Country:US
Mailing Address - Phone:901-725-8347
Mailing Address - Fax:901-259-7637
Practice Address - Street 1:6286 BRIARCREST AVE STE 110
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-4023
Practice Address - Country:US
Practice Address - Phone:901-641-3000
Practice Address - Fax:901-259-1698
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7764225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN620819926OtherCIGNA
AR110318002Medicaid
TN4164332OtherBCBS
TN620819926OtherTRICARE
MS620819926OtherBCBS
MS7187860Medicaid
TN9645091OtherAETNA
TN3371161Medicaid
MS06031726Medicaid
TN1512617Medicaid
TN0723280001OtherPALMETTO
TN620819926OtherAETNA
MS7187860Medicaid