Active NPI
Elizabeth Ellis
- Orthopedic Physical Therapist
- Berwyn, PA
National Provider Identifier
1043987019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT029800
- Practice address
- 1175 Lancaster Ave
Berwyn, PA 19312-1297 - Phone
- (610) 651-8282
- NPI assigned
- Aug 26, 2021
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT029800 | PA | Primary |
Addresses
Primary practice location
1175 Lancaster Ave
Berwyn, PA 19312-1297
Mailing address
475 Allendale Rd Ste 206
King of Prussia, PA 19406-1495
Phone (610) 270-0370
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT029800 | PA | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1043987019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 ALLENDALE RD STE 206",
"city": "KING OF PRUSSIA",
"state": "PA",
"postal_code": "194061495",
"telephone_number": "610-270-0370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 LANCASTER AVE",
"city": "BERWYN",
"state": "PA",
"postal_code": "193121297",
"telephone_number": "610-651-8282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-26",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "PA",
"license": "PT029800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.