Elena Marilynn Haller

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA.0014429 Issued in CO

Practice address

4864 Fir Dr Apt B
Usaf Academy, CO 80840-5214

Phone

(713) 409-0720

NPI assigned

Aug 14, 2018

Last updated

Aug 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1083193601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4864 FIR DR APT B",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808405214",
            "telephone_number": "713-409-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4864 FIR DR APT B",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808405214",
            "telephone_number": "713-409-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLER",
        "first_name": "ELENA",
        "middle_name": "MARILYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA.0014429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blaine Guenther, DMD
• Jenny Guivens, MS, RD, CDE
• Andrew J Gusty, MD
• Curtis L Hagerman, LCSW
• Samiyah Hall
• Lori A Hamm, O.D.
• Kurtis Gene Hammack, D.D.S.
• Glen Andrew Handley, OT.0007619
• Karen Keen Harmon, LCSW
• Kristene A Harris, LCSW

• Physical Therapy Assistant in Usaf Academy, CO
• Providers in Usaf Academy, CO by specialty
• Physical Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.