Active NPI
Janell Marie Eisenhut, PT
- Physical Therapist
- Anderson, IN
National Provider Identifier
1073883641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05010680A
- Practice address
- 4020 Columbus Ave
Anderson, IN 46013-5010 - Phone
- (765) 641-7605
- Fax
- (765) 641-7607
- NPI assigned
- Jan 12, 2012
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05010680A | IN | Primary |
Addresses
Primary practice location
4020 Columbus Ave
Anderson, IN 46013-5010
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201060310 | Medicaid | IN |
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 |
|---|---|---|---|
| 05010680A | IN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alotta Therapy,LLC | Physical Therapist | Past | Accepting new patients |
| Advanced Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
| Advanced Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 3
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.
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- Indianapolis, IN
- NPI 1316940505
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- Durable Medical Equipment & Medical Supplies
- Indianapolis, IN
- NPI 1700595089
Physical Therapist
-
- Physical Therapist
- Lafayette, IN
- NPI 1376813014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338768000000",
"number": "1073883641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-3251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 COLUMBUS AVE",
"city": "ANDERSON",
"state": "IN",
"postal_code": "460135010",
"telephone_number": "765-641-7605",
"fax_number": "765-641-7607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISENHUT",
"first_name": "JANELL",
"middle_name": "MARIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-12",
"last_updated": "2012-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05010680A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201060310",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Anderson, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.