Active NPI
Elissa Fjeldheim
- Occupational Therapist
- Peoria, AZ
National Provider Identifier
1275011843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTH-007077
- Practice address
- 9385 W Donald Dr
Peoria, AZ 85383-2988 - Phone
- (407) 446-5854
- NPI assigned
- Aug 5, 2018
- Last updated
- Aug 5, 2018
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OTH-007077 | AZ | Primary |
Addresses
Primary practice location
9385 W Donald Dr
Peoria, AZ 85383-2988
Mailing address
2026 E Patrick LN
Phoenix, AZ 85024-7538
Phone (407) 446-5854
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
| License | State | Type | Specialty |
|---|---|---|---|
| OTH-007077 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533427200000",
"number": "1275011843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2026 E PATRICK LN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850247538",
"telephone_number": "407-446-5854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9385 W DONALD DR",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853832988",
"telephone_number": "407-446-5854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FJELDHEIM",
"first_name": "ELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-05",
"last_updated": "2018-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "OTH-007077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.