Active NPI
Payton Penza, PT
- Pediatric Physical Therapist
- Warren, OH
National Provider Identifier
1265265847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT020793
- Practice address
- 2253 Atlantic St NE
Warren, OH 44483-4470 - Phone
- (330) 373-4500
- NPI assigned
- Aug 20, 2024
- Last updated
- Aug 20, 2024
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT020793 | OH | Primary |
Addresses
Primary practice location
2253 Atlantic St NE
Warren, OH 44483-4470
Mailing address
2490 Beech St
Girard, OH 44420-3101
Phone (330) 622-0657
Other practice location 1
120 E Margaret Ave
Niles, OH 44446-1920
Phone (330) 989-5093
Other practice location 2
2020 Willard Ave SE
Warren, OH 44484-5061
Phone (330) 675-8700
Other practice location 3
905 Milton Blvd
Newton Falls, OH 44444-9707
Phone (330) 872-0695
Other practice location 4
1015 N Leavitt Rd
Leavittsburg, OH 44430-9644
Phone (330) 989-0800
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 |
|---|---|---|---|
| PT020793 | OH | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724112000000",
"number": "1265265847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2490 BEECH ST",
"city": "GIRARD",
"state": "OH",
"postal_code": "444203101",
"telephone_number": "330-622-0657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2253 ATLANTIC ST NE",
"city": "WARREN",
"state": "OH",
"postal_code": "444834470",
"telephone_number": "330-373-4500"
}
],
"practiceLocations": [
{
"address_1": "120 E Margaret Ave",
"address_purpose": "LOCATION",
"city": "Niles",
"state": "OH",
"postal_code": "444461920",
"country_code": "US",
"telephone_number": "330-989-5093",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2020 Willard Ave SE",
"address_purpose": "LOCATION",
"city": "Warren",
"state": "OH",
"postal_code": "444845061",
"country_code": "US",
"telephone_number": "330-675-8700",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "905 Milton Blvd",
"address_purpose": "LOCATION",
"city": "Newton Falls",
"state": "OH",
"postal_code": "444449707",
"country_code": "US",
"telephone_number": "330-872-0695",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1015 N Leavitt Rd",
"address_purpose": "LOCATION",
"city": "Leavittsburg",
"state": "OH",
"postal_code": "444309644",
"country_code": "US",
"telephone_number": "330-989-0800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PENZA",
"first_name": "PAYTON",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-20",
"last_updated": "2024-08-20",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "OH",
"license": "PT020793",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.