Individual provider Active NPI

Amy Chenoweth

  • Occupational Therapist
  • Port Orange, FL
National Provider Identifier
1134530298
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
116103 Issued in TX
Practice address
5535 S Williamson Blvd
Suite 774
Port Orange, FL 32128-8311
Phone
(800) 330-7711
Fax
(386) 944-7202
NPI assigned
May 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 116103 TX Primary

Addresses

Primary practice location

5535 S Williamson Blvd
Suite 774
Port Orange, FL 32128-8311

Mailing address

5535 S Williamson Blvd
Suite 774
Port Orange, FL 32128-8311
Phone (800) 330-7711

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

LicenseStateTypeSpecialty
116103TXMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1134530298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD",
            "address_2": "SUITE 774",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288311",
            "telephone_number": "800-330-7711",
            "fax_number": "386-944-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD",
            "address_2": "SUITE 774",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288311",
            "telephone_number": "800-330-7711",
            "fax_number": "386-944-7202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENOWETH",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-12",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "116103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.