Change of Pace Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CHANGE OF PACE PHYSICAL THERAPY

Practice address

725 Harvard Dr
Owensboro, KY 42301-6185

Phone

(270) 231-6868

NPI assigned

Dec 8, 2020

Organization subpart

No

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

Authorized official

Name

Tammy S. Cummings, PT

Title

Owner

Phone

(270) 231-6868

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1639775463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 298",
            "city": "UTICA",
            "state": "KY",
            "postal_code": "423760298",
            "telephone_number": "270-231-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 HARVARD DR",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423016185",
            "telephone_number": "270-231-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGE OF PACE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "CUMMINGS",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-231-6868",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100725450",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Owensboro, KY
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• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.