Ted Ellquist, PT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

36493 Issued in CA

Legal business name

TED ELLQUIST, PT

Practice address

2466 Murdock Dr
Santa Rosa, CA 95404-2207

Phone

(503) 358-8278

NPI assigned

Aug 31, 2006

Last updated

Sep 20, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ted Ian Ellquist, P.T.

Title

Staff PT

Phone

(503) 358-8278

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ted Ellquist, PT Other name

Locations

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1053422485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2466 MURDOCK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954042207",
            "telephone_number": "503-358-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2466 MURDOCK DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954042207",
            "telephone_number": "503-358-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TED ELLQUIST, PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "ELLQUIST",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "IAN",
        "authorized_official_title_or_position": "STAFF PT",
        "authorized_official_telephone_number": "503-358-8278",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "CA",
            "license": "36493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1770516734",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA LICENSE",
            "identifier": "36493",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ted Ellquist, PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nicholas Taylor
• Miriam Tcheng
• Michael Tchudi, LPCC 20961
• Pamela Neel Teague, LCSW
• Hannah Teal
• Annamaria Tedeschi
• Monica Lys Teixido, RN, PHN
• Angela Tejeda, LCSW
• Telecare Corporation (Kaiser Ict North Bay Satellite)
• Telecare Corporation (Telecare Sonoma ACT)

• Physical Therapy Clinic/Center in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; 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.