Active NPI
Emily Vickers, PT, DPT, PCS
- Pediatric Physical Therapist
- Clinton, IA
National Provider Identifier
1194139741
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 004841
- Practice address
- 1377 11TH St NW
Clinton, IA 52732-5068 - Phone
- (563) 241-4230
- Fax
- (563) 519-4235
- NPI assigned
- Jun 11, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 004841 | IA | Primary |
Addresses
Primary practice location
1377 11TH St NW
Clinton, IA 52732-5068
Mailing address
583 Woodland Dr
Clinton, IA 52732-3620
Phone (615) 308-5193
Other practice location 1
4100 S Ferdon Blvd
Ste A-1
Crestview, FL 32536-5252
Phone (850) 682-8388
Other practice location 2
4401 E Colonial Dr
Orlando, FL 32803-5200
Phone (407) 898-5060
Other names 1
- Emily Vickers Holt
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592265600000",
"number": "1194139741",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "583 WOODLAND DR",
"city": "CLINTON",
"state": "IA",
"postal_code": "527323620",
"telephone_number": "615-308-5193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1377 11TH ST NW",
"city": "CLINTON",
"state": "IA",
"postal_code": "527325068",
"telephone_number": "563-241-4230",
"fax_number": "563-519-4235"
}
],
"practiceLocations": [
{
"address_1": "4100 S Ferdon Blvd",
"address_2": "Ste A-1",
"address_purpose": "LOCATION",
"city": "Crestview",
"state": "FL",
"postal_code": "325365252",
"country_code": "US",
"telephone_number": "850-682-8388",
"fax_number": "850-682-7463",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4401 E Colonial Dr",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "328035200",
"country_code": "US",
"telephone_number": "407-898-5060",
"fax_number": "407-898-5185",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VICKERS",
"first_name": "EMILY",
"credential": "PT, DPT, PCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-11",
"last_updated": "2020-06-16",
"certification_date": "2020-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "IA",
"license": "004841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "HOLT",
"middle_name": "VICKERS",
"credential": "PT, DPT, PCS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.