Active NPI
Catherine Penn Childress, DPT
- Orthopedic Physical Therapist
- St Augustine, FL
National Provider Identifier
1144350778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT22844
- Practice address
- 1690 US Highway 1 S Ste a
St Augustine, FL 32084-6024 - Phone
- (904) 810-2101
- Fax
- (904) 810-2106
- NPI assigned
- Mar 6, 2007
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT22844 | FL | Primary |
Addresses
Primary practice location
1690 US Highway 1 S Ste a
St Augustine, FL 32084-6024
Mailing address
33201 Harbour Vista Cir
St Augustine, FL 32080-5144
Phone (904) 810-2101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT22844 | Other | FL | LICENSE |
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 |
|---|---|---|---|
| PT22844 | FL | MD | Orthopedic Physical Therapist |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1144350778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33201 HARBOUR VISTA CIR",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320805144",
"telephone_number": "904-810-2101",
"fax_number": "904-810-2106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1690 US HIGHWAY 1 S STE A",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320846024",
"telephone_number": "904-810-2101",
"fax_number": "904-810-2106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHILDRESS",
"first_name": "CATHERINE",
"middle_name": "PENN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "FL",
"license": "PT22844",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "PT22844",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in St Augustine, FL
- Courtney Chesek, LPN
- Kayla Chesser-Murray, APRN
- Leh-Ha Lucia Chew, DDS
- Children's Home Society of Florida
- Children's Home Society of Florida
- Chinasa LLC (Abundant Homemakers)
- Chiro & Laser Pain Relief Center of St Augustine LLC
- Chiro & Laser St. Augustine, PLLC
- Christy M Chong, ARNP
- Kok L. Chong, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.