Active NPI
Mary Elizabeth Manderson, PT
- Pediatric Physical Therapist
- El Cajon, CA
National Provider Identifier
1083620082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 15874
- Practice address
- 1246 E Main St Ste 109
El Cajon, CA 92021-7206 - Phone
- (619) 441-1200
- Fax
- (619) 441-1215
- NPI assigned
- Jul 31, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 15874 | CA | Primary |
Addresses
Primary practice location
1246 E Main St Ste 109
El Cajon, CA 92021-7206
Mailing address
120 Thrasher Way
El Cajon, CA 92020-2632
Phone (619) 469-0810
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elnel, Inc. a California Corporation Total Physical Therapy | Pediatrics | Past | Accepting new patients |
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.
-
- Physical Therapy Clinic/Center
- Chula Vista, CA
- NPI 1386681732
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519776000000",
"number": "1083620082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 THRASHER WAY",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920202632",
"telephone_number": "619-469-0810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1246 E MAIN ST STE 109",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920217206",
"telephone_number": "619-441-1200",
"fax_number": "619-441-1215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDERSON",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-31",
"last_updated": "2018-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CA",
"license": "15874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Cajon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.