Individual provider Active NPI

Elizabeth Ellen Ansley, DPT

  • Physical Therapist
  • Bremerton, WA
National Provider Identifier
1306191101
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT60313041 Issued in WA
Practice address
4060 Wheaton Way
Ste. C
Bremerton, WA 98310-3500
Phone
(360) 479-8477
Fax
(360) 479-8417
NPI assigned
Jul 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT60313041 WA Primary

Addresses

Primary practice location

4060 Wheaton Way
Ste. C
Bremerton, WA 98310-3500

Mailing address

4040 Orchard St W
Ste. 100
Fircrest, WA 98466-6606
Phone (253) 564-1560

Other identifiers 1

IdentifierTypeStateIssuer
1306191101MedicaidWA

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

LicenseStateTypeSpecialty
PT60313041WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MVP Physical Therapy, Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1342483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1306191101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 ORCHARD ST W",
            "address_2": "STE. 100",
            "city": "FIRCREST",
            "state": "WA",
            "postal_code": "984666606",
            "telephone_number": "253-564-1560",
            "fax_number": "253-564-4449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 WHEATON WAY",
            "address_2": "STE. C",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103500",
            "telephone_number": "360-479-8477",
            "fax_number": "360-479-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANSLEY",
        "first_name": "ELIZABETH",
        "middle_name": "ELLEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-17",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60313041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306191101",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.