Individual provider Active NPI

Paige Hurlburt

  • Physical Therapist
  • Tampa, FL
National Provider Identifier
1447014162
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT41295 Issued in FL
Practice address
6633 Gunn Hwy
Tampa, FL 33625-4056
Phone
(813) 519-0604
NPI assigned
Feb 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT41295 FL Primary

Addresses

Primary practice location

6633 Gunn Hwy
Tampa, FL 33625-4056

Mailing address

21756 State Road 54 Ste 102
Lutz, FL 33549-2905

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240220002843 FL Practitioner - Physical Therapist in Private Practice 9931543709 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Performance and Physical Therapies Northdale LLC Physical Therapist CurrentSince Feb 12, 2024 Accepting new patients
Optimal Performance and Physical Therapies Northdale LLC Physical Therapist CurrentSince Feb 12, 2024 Accepting new patients

Locations

21756 State Road 54
Ste 102
Lutz, FL 33549
Phone (813) 279-6234

6633 Gunn Hwy
Tampa, FL 33625
Phone (813) 519-0604

3903 Northdale Blvd
Ste 111W
Tampa, FL 33624
Phone (813) 381-6778

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1707782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1447014162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21756 STATE ROAD 54 STE 102",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335492905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6633 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254056",
            "telephone_number": "813-519-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLBURT",
        "first_name": "PAIGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-13",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT41295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.