Eliza Ermold, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119005752 Issued in VA

Practice address

1940 S West Blvd BLDG a
Vineland, NJ 08360-7024

Phone

(856) 690-9977

Fax

(856) 507-9918

NPI assigned

Mar 21, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Eliza Entrekin Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLCGroup PAC ID 1557388436, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLC

  • Orthopaedic Surgery Physician
  • Vineland, NJ
  • NPI 1396812574
  Medicare reassignment Care Compare group NPD
• Ivyrehab Network Inc.

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1174577274

  Occupational Therapist

  Medicare reassignment NPD
• Fox Rehabilitation Services Inc

  • Physical Therapist
  • Wilmington, DE
  • NPI 1326092503

  NJ, Occupational Therapist

  Medicare reassignment NPD
• Ivyrehab Network Inc

  • Physical Therapist
  • Hoboken, NJ
  • NPI 1861623753

  Occupational Therapist

  NPD
• Ivyrehab Network, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Cranford, NJ
  • NPI 1699590265

  Occupational Therapist

  NPD
• Premier Orthopaedic and Sports Medicine Assoc of Southern NJ LLC

  • Orthopaedic Surgery Physician
  • Mullica Hill, NJ
  • NPI 1457092611
  NPD
• Jag-One Physical Therapy, LLC

  • Physical Therapist
  • West Orange, NJ
  • NPI 1518017144
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1255457651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 MOTOR PKWY STE 307",
            "city": "ISLANDIA",
            "state": "NY",
            "postal_code": "117495258",
            "telephone_number": "631-580-5200",
            "fax_number": "631-580-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 S WEST BLVD BLDG A",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607024",
            "telephone_number": "856-690-9977",
            "fax_number": "856-507-9918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERMOLD",
        "first_name": "ELIZA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00441400",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119005752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZA",
            "last_name": "ENTREKIN",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Encompass Health Rehabilitation Hospital of Vineland, LLC (Encompass Health Rehabilitation Hospital of Vineland)
• Mary Allison Endicott, PA-C
• Endoscopy Center of South Jersey P C
• Stephanie Mazzoni Engle, LCSW
• Carla Victoria Enriquez, M.D., F.A.A.P.
• Esa South Jersey Bariatrics, P.a.
• Karan K Estwick, DDS
• Ebony Evans, LPN
• Karl Bruce Evans
• Rashele Evans

• Occupational Therapist in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.