Individual provider Active NPI

Elizabeth Wojcik, P.T.

  • Physical Therapist
  • Mentor, OH
National Provider Identifier
1174796593
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT11515 Issued in OH
Practice address
9500 Mentor Ave
Suite 210
Mentor, OH 44060-8713
Phone
(440) 352-0934
Fax
(440) 352-7562
NPI assigned
Apr 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT11515 OH Primary

Addresses

Primary practice location

9500 Mentor Ave
Suite 210
Mentor, OH 44060-8713

Mailing address

5340 Royalton Rd
P O Box 33396
North Royalton, OH 44133-4008
Phone (440) 230-1133

Other identifiers 1

IdentifierTypeStateIssuer
PT11515OtherOHSTATE LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT11515OHMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1174796593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5340 ROYALTON RD",
            "address_2": "P O BOX 33396",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441334008",
            "telephone_number": "440-230-1133",
            "fax_number": "440-230-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MENTOR AVE",
            "address_2": "SUITE 210",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440608713",
            "telephone_number": "440-352-0934",
            "fax_number": "440-352-7562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOJCIK",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT11515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PT11515",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.