Paige Blackmon Stivers, PT, DPT
Individual provider Active NPI Physical Therapist · Olathe, KS
NPI 1114490349 · NPPES record last updated Aug 21, 2023
Key facts
- NPI
- 1114490349
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11-07398 (KS)
- Practice address
- 1061 E 151St St
Olathe, KS 66062-3417 - Phone
- (913) 829-3133
- NPI assigned
- Jan 10, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230914002254 | KS | Practitioner - Physical Therapist in Private Practice | 5193189736 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3123299 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Select Physical Therapy Holdings, Inc. | Physical Therapist | Current | Accepting new patients |
| Select Physical Therapy Holdings Inc | Current |
Accepting new patients | |
| Select Physical Therapy Holdings, Inc. | Current |
Accepting new patients | |
| Select Physical Therapy Holdings, Inc. | Past | Accepting new patients | |
| Bir JV LLP | Past | Accepting new patients |
Locations
1333 Meadowlark Ln
Ste 104
Kansas City, KS 66102
Phone (913) 287-8815
5922 Barkley St
Ste 201B
Mission, KS 66202
Phone (913) 229-9440
5922 Barkley St
Mission, KS 66202
Phone (913) 229-9440
1061 E 151st St
Olathe, KS 66062
Phone (913) 829-3133
15917 Antioch Rd
Overland Park, KS 66223
Phone (913) 239-9536
4001 Indian Creek Pkwy
Overland Park, KS 66207
Phone (913) 385-0075
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3123299 | TX | |
| Physical Therapist | 225100000X | 11-07398 | KS | Yes |
Addresses
Primary practice location
1061 E 151St St
Olathe, KS 66062-3417
Mailing address
701 W Broad St Ste 100
Bethlehem, PA 18018-5229
Phone (913) 829-3133
Other practice location 1
15917 Antioch Rd
Overland Park, KS 66223-2924
Phone (913) 239-9539
Other practice location 2
4001 Indian Creek Pkwy
Overland Park, KS 66207-4030
Phone (913) 385-0075
Other practice location 3
1333 Meadowlark Ln Ste 104
Kansas City, KS 66102-1200
Phone (913) 287-8815
Other practice location 4
5922 Barkley St Ste 201B
Mission, KS 66202-3269
Phone (913) 229-9440
Other providers in Olathe, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.