Active NPI
Philip Elsas, ITDS CERTIFIED
- Developmental Therapist
- Jacksonville, FL
National Provider Identifier
1275747016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 4101-1 College St
Jacksonville, FL 32205-5318 - Phone
- (904) 387-0370
- Fax
- (904) 387-0156
- NPI assigned
- May 10, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
4101-1 College St
Jacksonville, FL 32205-5318
Mailing address
4101-1 College St
Jacksonville, FL 32205-5318
Phone (904) 387-0370
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275747016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101-1 COLLEGE ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322055318",
"telephone_number": "904-387-0370",
"fax_number": "904-387-0156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101-1 COLLEGE ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322055318",
"telephone_number": "904-387-0370",
"fax_number": "904-387-0156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELSAS",
"first_name": "PHILIP",
"credential": "ITDS CERTIFIED",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.