Ellen Mehalic, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305208287 Issued in VA

Practice address

3960 Valley Gateway Blvd Ste A3
Roanoke, VA 24012-6859

Phone

(540) 772-8022

Fax

(540) 772-0294

NPI assigned

Aug 27, 2013

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

• Krasniak Krasniak Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1377561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1356775233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183436",
            "telephone_number": "540-772-8022",
            "fax_number": "540-772-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 VALLEY GATEWAY BLVD STE A3",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240126859",
            "telephone_number": "540-772-8022",
            "fax_number": "540-772-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEHALIC",
        "first_name": "ELLEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-27",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "62036789",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRASNIAK",
            "last_name": "KRASNIAK",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Medical Services of America Inc
• Angel Antonio Medina-Bravo, M.D.
• Ramon Luis Medina, CRNA
• Andrew Stevens Meehan, D.O.
• Christina W Megow
• Brian James Meier, M.D.
• Michele Meinhart, FNP
• Sherilyn Meixner, LCSW
• Nina Meletiche
• Eric Mellencamp, M.D.

• Physical Therapist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.

Verify at the official NPI Registry.