Active NPI
Elise Marie Anderson, LPTA
- Physical Therapy Assistant
- Lincoln, IL
National Provider Identifier
1154538007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 160-000990
- Practice address
- 200 Stahlhut Dr
Lincoln, IL 62656-5066 - Phone
- (217) 605-5503
- NPI assigned
- May 17, 2007
- Last updated
- Jun 13, 2012
- 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 Therapy Assistant | 225200000X | 160-000990 | KS | Primary |
Addresses
Primary practice location
200 Stahlhut Dr
Lincoln, IL 62656-5066
Mailing address
217 N Gillett St
Elkhart, IL 62634-6002
Phone (217) 415-6893
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 |
|---|---|---|---|
| 160-000990 | KS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339545600000",
"number": "1154538007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 N GILLETT ST",
"city": "ELKHART",
"state": "IL",
"postal_code": "626346002",
"telephone_number": "217-415-6893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 STAHLHUT DR",
"city": "LINCOLN",
"state": "IL",
"postal_code": "626565066",
"telephone_number": "217-605-5503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "ELISE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LPTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2012-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "160-000990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.