Active NPI
Paige Alyssa Gutierrez, DPT
- Physical Therapist
- Saint Charles, MO
National Provider Identifier
1023670312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2019021019
- Practice address
- 1552 Country Club Plaza Dr
Saint Charles, MO 63303-3859 - Phone
- (636) 724-1127
- NPI assigned
- Jul 8, 2019
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2019021019 | MO | Primary |
Addresses
Primary practice location
1552 Country Club Plaza Dr
Saint Charles, MO 63303-3859
Mailing address
1511 Aberdeen CT
Saint Charles, MO 63303-3853
Phone (630) 618-0287
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 |
|---|---|---|---|
| 2019021019 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562544000000",
"number": "1023670312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1511 ABERDEEN CT",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633033853",
"telephone_number": "630-618-0287"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1552 COUNTRY CLUB PLAZA DR",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633033859",
"telephone_number": "636-724-1127"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "PAIGE",
"middle_name": "ALYSSA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-07-08",
"last_updated": "2019-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MO",
"license": "2019021019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.