MEDICARE: STEVEN T CHENOWETH PT

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT003663	GA
2	225100000X	Physical Therapist	PT 13398	FL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00319893	OTHER	GA	RR MEDICARE
10	P00367613	OTHER	FL	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1760488258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN T CHENOWETH PT

Provider Business Mailing Address
First Line	:	PO BOX 1975
Second Line	:
City	:	ROME
State	:	GA
Zip	:	30162-1975
Country	:	US
Telephone Number	:	904-432-7558
Fax Number	:	866-858-7371

Provider Business Practice Location Address
First Line	:	308 1/2 CENTRE ST OFC 2
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-4241
Country	:	US
Telephone Number	:	904-432-7558
Fax Number	:	866-858-7371

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	07/21/2022