Individual provider Active NPI

Elizabeth Harris, PT, DPT

  • Physical Therapist
  • Draper, UT
National Provider Identifier
1053800136
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
26955 Issued in MD
Practice address
65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096
Phone
(385) 308-8034
NPI assigned
May 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 298022 CA
Physical Therapist 225100000X 3405213732 VA
Physical Therapist 225100000X 26955 MD Primary

Addresses

Primary practice location

65 E Wadsworth Park Dr Ste 230
Draper, UT 84020-8096

Mailing address

274 Providence Rd
Annapolis, MD 21409-6323

Other practice location 1

2661 Riva Road
bld 600, ste 601
Annapolis, MD 21401-7343
Phone (410) 266-6626

Other practice location 2

3300 Broadway
Oakland, CA 94611-5718
Phone (800) 943-8099

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

LicenseStateTypeSpecialty
298022CAMDPhysical Medicine & Rehabilitation Physician
3405213732VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Annapolis Family Physical Therapy, Inc Physical Therapist CurrentSince Sep 20, 2020 Accepting new patients

Locations

2564 Riva Rd
Annapolis, MD 21401
Phone (410) 266-6626

2006 Industrial Dr
Annapolis, MD 21401
Phone (410) 266-7174

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1053800136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 PROVIDENCE RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214096323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 E WADSWORTH PARK DR STE 230",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208096",
            "telephone_number": "385-308-8034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2661 Riva Road",
            "address_2": "bld 600, ste 601",
            "address_purpose": "LOCATION",
            "city": "Annapolis",
            "state": "MD",
            "postal_code": "214017343",
            "country_code": "US",
            "telephone_number": "410-266-6626",
            "fax_number": "410-266-3026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3300 Broadway",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946115718",
            "country_code": "US",
            "telephone_number": "800-943-8099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ELIZABETH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-04",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "298022",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "3405213732",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.