Active NPI
Jamie Eilts, PT
- Physical Therapist
- Peoria, IL
National Provider Identifier
1104072016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-016571
- Practice address
- 303 N William Kumpf Blvd
Peoria, IL 61605-2507 - Phone
- (309) 676-5546
- NPI assigned
- Aug 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 070-016571 | IL | Primary |
Addresses
Primary practice location
303 N William Kumpf Blvd
Peoria, IL 61605-2507
Mailing address
303 N William Kumpf Blvd
Peoria, IL 61605-2507
Phone (309) 676-5546
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 |
|---|---|---|---|
| 070-016571 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic Associates of Peoria, S.C. | 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.
-
- Durable Medical Equipment & Medical Supplies
- Peoria, IL
- NPI 1467418350
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218499200000",
"number": "1104072016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 N WILLIAM KUMPF BLVD",
"city": "PEORIA",
"state": "IL",
"postal_code": "616052507",
"telephone_number": "309-676-5546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 N WILLIAM KUMPF BLVD",
"city": "PEORIA",
"state": "IL",
"postal_code": "616052507",
"telephone_number": "309-676-5546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EILTS",
"first_name": "JAMIE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-12",
"last_updated": "2008-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-016571",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.