NPIMap

Organization Active NPI

El Paso Pelvic Health PLLC

  • Physical Therapist
  • El Paso, TX
National Provider Identifier
1124666052
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EL PASO PELVIC HEALTH PLLC
Practice address
11500 Pellicano Dr
Ste a-9
El Paso, TX 79936-6064
Phone
(915) 209-7124
Fax
(915) 247-4474
NPI assigned
Dec 10, 2019
Last updated
Jul 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Authorized official

Name
Elizabeth Willison, PT, DPTNPI 1669943841
Title
Managing Member
Phone
(915) 209-7124

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

11500 Pellicano Dr
Ste a-9
El Paso, TX 79936-6064

Mailing address

11500 Pellicano Dr Ste a-9
El Paso, TX 79936-6064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200114000377 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2769817105 Receives reassigned benefits from 6 practitioners
Practice locations: El Paso, TX

National Provider Directory

National Provider Directory

Locations

11500 Pellicano Dr
Ste A-9
El Paso, TX 79936
Phone (915) 209-7124

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1575936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1124666052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 PELLICANO DR STE A-9",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 PELLICANO DR",
            "address_2": "STE A-9",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799366064",
            "telephone_number": "915-209-7124",
            "fax_number": "915-247-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL PASO PELVIC HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-10",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "WILLISON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "915-209-7124",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.