Individual provider Active NPI

Paige Carissa Chenoweth-Allen, PT, DPT

  • Physical Therapist
  • Panama City Beach, FL
National Provider Identifier
1255605093
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29954 Issued in FL
Practice address
12111 Panama City Beach Pkwy
Panama City Beach, FL 32407-2609
Phone
(850) 236-7497
Fax
(850) 236-7499
NPI assigned
Feb 24, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 38588 CA
Physical Therapist 225100000X 2017018683 MO
Physical Therapist 225100000X 29954 FL Primary

Addresses

Primary practice location

12111 Panama City Beach Pkwy
Panama City Beach, FL 32407-2609

Mailing address

4146 Juniata St
Saint Louis, MO 63116-3931
Phone (951) 359-6172

Other practice location 1

11300 Sorrento Valley Rd Ste 101
San Diego, CA 92121-1329
Phone (858) 452-0300

Other names 1

  • Paige Carissa Chenoweth Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120620000722 CA Practitioner - Physical Therapist in Private Practice 4183888209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

16185 Los Gatos Blvd
Suite 205
Los Gatos, CA 95032-4569
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 38588CAMDPhysical Therapist
29954FLMDPhysical Therapist
2017018683MOMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Aug 28, 2024 Accepting new patients
Pilates of Torrey Hills Inc. Physical Therapist PastSince May 1, 2015 Accepting new patients

Locations

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 409-4167

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1255605093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4146 JUNIATA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631163931",
            "telephone_number": "951-359-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12111 PANAMA CITY BEACH PKWY",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072609",
            "telephone_number": "850-236-7497",
            "fax_number": "850-236-7499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11300 Sorrento Valley Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921211329",
            "country_code": "US",
            "telephone_number": "858-452-0300",
            "fax_number": "858-452-0600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHENOWETH-ALLEN",
        "first_name": "PAIGE",
        "middle_name": "CARISSA",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 38588",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2017018683",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "29954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAIGE",
            "last_name": "CHENOWETH",
            "middle_name": "CARISSA",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.