Active NPI
Erin Ellenwood, DT
- Developmental Therapist
- Fishers, IN
National Provider Identifier
1366516908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 11659 Tylers Close
Fishers, IN 46037-4359 - Phone
- (317) 250-2431
- NPI assigned
- Nov 17, 2006
- 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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
11659 Tylers Close
Fishers, IN 46037-4359
Mailing address
11659 Tylers Close
Fishers, IN 46037-4359
Phone (317) 250-2431
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200681960 | Medicaid | IN |
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": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557792000000",
"number": "1366516908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11659 TYLERS CLOSE",
"city": "FISHERS",
"state": "IN",
"postal_code": "460374359",
"telephone_number": "317-250-2431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11659 TYLERS CLOSE",
"city": "FISHERS",
"state": "IN",
"postal_code": "460374359",
"telephone_number": "317-250-2431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLENWOOD",
"first_name": "ERIN",
"credential": "DT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-17",
"last_updated": "2019-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200681960",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fishers, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.