Elizabeth Polovich Gilreath, PT – Physical Therapist

Key facts

NPI: 1154535474
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapist 225100000X
License: PTH923 (AL)
Practice address: 110 Elecia LN
Foley, AL 36535-8970
Phone: (251) 971-1436
NPI assigned: May 9, 2007
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
PTH923	AL	MD	Physical Therapist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapist	225100000X	PTH923	AL	Yes

Addresses

Primary practice location

110 Elecia LN
Foley, AL 36535-8970

Mailing address

116 High Pines RDG
Fairhope, AL 36532-6312
Phone (251) 928-3803

Other identifiers

Identifier	Type	State	Issuer
515-29267	Other	AL	BCBS PROVIDER NUMBER

Other names

Mrs. Beth Polovich Gilreath Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154535474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 HIGH PINES RDG",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365326312",
            "telephone_number": "251-928-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ELECIA LN",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365358970",
            "telephone_number": "251-971-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILREATH",
        "first_name": "ELIZABETH",
        "middle_name": "POLOVICH",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "515-29267",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "GILREATH",
            "middle_name": "POLOVICH",
            "prefix": "MRS.",
            "credential": "PT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Foley, AL

All providers in Foley, AL · Physical Therapist in Alabama

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.