Courtney Ellstrom, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT37207 Issued in CA

Practice address

1620 E Second St Ste Iandj
Beaumont, CA 92223-3171

Phone

(951) 370-1325

Fax

(951) 684-2980

NPI assigned

Jan 7, 2011

Last updated

Aug 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marketplace Physical Therapy Inc, a Professional CorporationGroup PAC ID 0244572964, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Marketplace Physical Therapy Inc, a Professional Corporation

  • Physical Therapy Clinic/Center
  • Riverside, CA
  • NPI 1285190942

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Total Wellness Inc

  • Physical Therapist
  • Riverside, CA
  • NPI 1043304942
  Medicare reassignment

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1104120054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3191B MISSION INN AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925074138",
            "telephone_number": "951-684-2874",
            "fax_number": "951-684-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 E SECOND ST STE IANDJ",
            "city": "BEAUMONT",
            "state": "CA",
            "postal_code": "922233171",
            "telephone_number": "951-370-1325",
            "fax_number": "951-684-2980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3191 Mission Inn Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925074188",
            "country_code": "US",
            "telephone_number": "951-376-2692",
            "fax_number": "951-684-2980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLSTROM",
        "first_name": "COURTNEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-07",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT37207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne Marie Duebbert, LMFT
• Leeanne Dunwoody
• Jasmine Ashley Dwyer, MD
• Aubrianne Easton
• Alexandra Edelbach
• Susannah Reay Elton, PA-C
• Angelica Elizabeth Espinoza
• Cathleen Vanessa Gutierrez Exconde-Mercado, RN, NP
• Faculty Medical Group of Llusm (Llu Faculty Med. GR. /Radiology)
• Faculty Physicians and Surgeons of Llusm

• Physical Therapist in Beaumont, CA
• Providers in Beaumont, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.