Active NPI
Emmylou Berou Restauro, PHYSICAL THERAPIST
- Physical Therapist
- Marion, IN
National Provider Identifier
1285840702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05007660A
- Practice address
- 1800 N Wabash Rd Ste 300
Marion, IN 46952-1300 - Phone
- (765) 651-3229
- Fax
- (765) 651-3227
- NPI assigned
- May 14, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05007660A | IN | Primary |
Addresses
Primary practice location
1800 N Wabash Rd Ste 300
Marion, IN 46952-1300
Mailing address
2498 Audri LN
Kokomo, IN 46901-7071
Phone (765) 461-7084
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 |
|---|---|---|---|
| 05007660A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285840702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2498 AUDRI LN",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469017071",
"telephone_number": "765-461-7084"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 N WABASH RD STE 300",
"city": "MARION",
"state": "IN",
"postal_code": "469521300",
"telephone_number": "765-651-3229",
"fax_number": "765-651-3227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESTAURO",
"first_name": "EMMYLOU",
"middle_name": "BEROU",
"name_prefix": "Mrs.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05007660A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IN
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.