Individual provider Active NPI

Elisabeth Bulliner, PT, DPT

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1447828629
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT37258 Issued in FL
Practice address
3414 Inwood Cir E
Jacksonville, FL 32207-5514
Phone
(810) 293-1986
NPI assigned
Jun 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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 PT37258 FL Primary

Addresses

Primary practice location

3414 Inwood Cir E
Jacksonville, FL 32207-5514

Mailing address

3414 Inwood Cir E
Jacksonville, FL 32207-5514
Phone (810) 293-1986

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

State licenses

LicenseStateTypeSpecialty
PT37258FLMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1447828629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 INWOOD CIR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075514",
            "telephone_number": "810-293-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 INWOOD CIR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075514",
            "telephone_number": "810-293-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLINER",
        "first_name": "ELISABETH",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT37258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.