Individual provider Active NPI

Victoria Chenoweth, PT

  • Physical Therapist
  • Olympia, WA
National Provider Identifier
1063286557
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT61501729 Issued in WA
Practice address
2102 Carriage St SW Ste B
Olympia, WA 98502-1049
Phone
(360) 866-0408
NPI assigned
Nov 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT61501729 WA Primary

Addresses

Primary practice location

2102 Carriage St SW Ste B
Olympia, WA 98502-1049

Mailing address

8521 Litt Dr SE Apt 303
Lacey, WA 98516-4615
Phone (360) 909-5028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231218001118 WA Practitioner - Physical Therapist in Private Practice 9234588161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Rehabilitation Group PC 192 clinicians

Practice addresses (Care Compare)

300 Lilly Rd NE
Suite B
Olympia, WA 98506-5428
Phone (360) 352-7352

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Oct 7, 2024 Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist Current Accepting new patients
Integrated Rehabilitation Group, PC Physical Therapist CurrentSince Oct 7, 2024 Accepting new patients

Locations

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

300 Lilly Rd NE
Ste B
Olympia, WA 98506
Phone (360) 352-7352

201 W North River Dr
Ste 510
Spokane, WA 99201
Phone (509) 323-0066

Organizations & group practices 19

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 19

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1063286557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8521 LITT DR SE APT 303",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985164615",
            "telephone_number": "360-909-5028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 CARRIAGE ST SW STE B",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985021049",
            "telephone_number": "360-866-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENOWETH",
        "first_name": "VICTORIA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-14",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT61501729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.