Active NPI
Jennifer M Elderkin
- Physical Therapy Assistant
- Andover, MA
National Provider Identifier
1114228756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3578
- Practice address
- 450 Lowell St
Andover, MA 01810-5305 - Phone
- (978) 745-4056
- NPI assigned
- Nov 13, 2010
- 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 Therapy Assistant | 225200000X | 3578 | MA | Primary |
Addresses
Primary practice location
450 Lowell St
Andover, MA 01810-5305
Mailing address
3305 Archstone Ave
Tewksbury, MA 01876-1880
Phone (978) 808-9941
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3578 | MA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1289606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289606400000",
"number": "1114228756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3305 ARCHSTONE AVE",
"city": "TEWKSBURY",
"state": "MA",
"postal_code": "018761880",
"telephone_number": "978-808-9941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 LOWELL ST",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018105305",
"telephone_number": "978-745-4056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDERKIN",
"first_name": "JENNIFER",
"middle_name": "M",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-11-13",
"last_updated": "2010-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MA",
"license": "3578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.