Individual provider Active NPI

Jill L Ehlen, PTA

  • Physical Therapy Assistant
  • Mount Ayr, IA
National Provider Identifier
1184869489
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
00675 Issued in IA
Practice address
1504 E South St
Mount Ayr, IA 50854-2260
Phone
(615) 896-6400
NPI assigned
Dec 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 00675 IA Primary

Addresses

Primary practice location

1504 E South St
Mount Ayr, IA 50854-2260

Mailing address

903 S Henderson Dr
Mount Ayr, IA 50854-2250
Phone (615) 896-6400

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

LicenseStateTypeSpecialty
00675IAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1184869489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 S HENDERSON DR",
            "city": "MOUNT AYR",
            "state": "IA",
            "postal_code": "508542250",
            "telephone_number": "615-896-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 E SOUTH ST",
            "city": "MOUNT AYR",
            "state": "IA",
            "postal_code": "508542260",
            "telephone_number": "615-896-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHLEN",
        "first_name": "JILL",
        "middle_name": "L",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-16",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IA",
            "license": "00675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Ayr, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.