Provider Demographics
NPI:1477442135
Name:CHAVIS, JASMINE D
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:D
Last Name:CHAVIS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2157 SHRIMP ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-8518
Mailing Address - Country:US
Mailing Address - Phone:843-864-3984
Mailing Address - Fax:
Practice Address - Street 1:2157 SHRIMP ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-8518
Practice Address - Country:US
Practice Address - Phone:843-864-3984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist