Paige Noelle Funderburk, OTD, CLT, NDT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

11449 Issued in CA

Practice address

4646 Narragansett Ave
San Diego, CA 92107-2902

Phone

(404) 455-0563

NPI assigned

Mar 30, 2007

Last updated

Aug 24, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Paige Noelle Cook Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14973/brand/8/csg/1/fhir/r4

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.

• DPT Holdings, LLC

  dba Doctors of Physical Therapy

  • Physical Therapist
  • Plainfield, IL
  • NPI 1689648602
  NPD
• Cortica Healthcare Inc

  dba Pediatric Neurology Therapeutics PC

  • Health Service Clinic/Center
  • San Diego, CA
  • NPI 1801288535
  NPD (past)
• Trellis Physical Therapy a Professional Rehab Group Inc.

  • Physical Therapist
  • Los Angeles, CA
  • NPI 1730245838
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471996800000",
    "number": "1881714350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 NARRAGANSETT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921072902",
            "telephone_number": "404-455-0563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 NARRAGANSETT AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921072902",
            "telephone_number": "404-455-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNDERBURK",
        "first_name": "PAIGE",
        "middle_name": "NOELLE",
        "name_prefix": "Dr.",
        "credential": "OTD, CLT, NDT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2016-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT004291",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "11449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAIGE",
            "last_name": "COOK",
            "middle_name": "NOELLE",
            "prefix": "DR.",
            "credential": "OTD, CLT, NDT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Function in Movement Physical Therapy
• Functional Athletics LLC (Egoscue of San Diego)
• Functional Physical Therapy Solutions Inc (Coastal Orthotics)
• Functionsmart
• Fundamental Health
• Brent W Fundingsland, M.D.
• Lisa Fundingsland
• Karl Dale Martin Fune
• Candi Funes
• Alan Gonzalo Funez

• Occupational Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; 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.