Individual provider Active NPI

Elisabet Maria Taylor, PT

  • Geriatric Physical Therapist
  • Bremerton, WA
National Provider Identifier
1366641276
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
PT00006132 Issued in WA
Practice address
140 S Marion Ave
Bremerton, WA 98312-3639
Phone
(360) 479-4747
Fax
(360) 478-6246
NPI assigned
Jul 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X PT00006132 WA Primary

Addresses

Primary practice location

140 S Marion Ave
Bremerton, WA 98312-3639

Mailing address

10066 Edgecombe PL NE
Bainbridge Island, WA 98110-4333
Phone (360) 479-4747

Other identifiers 1

IdentifierTypeStateIssuer
4111589MedicaidWA

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

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1366641276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10066 EDGECOMBE PL NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981104333",
            "telephone_number": "360-479-4747",
            "fax_number": "360-478-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S MARION AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983123639",
            "telephone_number": "360-479-4747",
            "fax_number": "360-478-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "ELISABET",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "WA",
            "license": "PT00006132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4111589",
            "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 Nov 28, 2016; 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.