Individual provider Active NPI

Debra J Elkins, PTA

  • Physical Therapy Assistant
  • Evansville, IN
National Provider Identifier
1457501660
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06002470A Issued in IN
Practice address
7300 E Indiana St
Suite 102
Evansville, IN 47715-2794
Phone
(812) 476-0409
Fax
(812) 476-1016
NPI assigned
Sep 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06002470A IN Primary

Addresses

Primary practice location

7300 E Indiana St
Suite 102
Evansville, IN 47715-2794

Mailing address

7300 E Indiana St
Suite 102
Evansville, IN 47715-2794
Phone (812) 476-0409

Other names 1

  • Debra J Smith Former name

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
06002470AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1457501660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 E INDIANA ST",
            "address_2": "SUITE 102",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152794",
            "telephone_number": "812-476-0409",
            "fax_number": "812-476-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 E INDIANA ST",
            "address_2": "SUITE 102",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152794",
            "telephone_number": "812-476-0409",
            "fax_number": "812-476-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELKINS",
        "first_name": "DEBRA",
        "middle_name": "J",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06002470A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRA",
            "last_name": "SMITH",
            "middle_name": "J",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.