Individual provider Active NPI

Elizabeth Mercedes Frick

  • Physical Therapy Assistant
  • Fort Wayne, IN
National Provider Identifier
1497212369
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06005287A Issued in IN
Practice address
4180 Sage Bluff Xing
Fort Wayne, IN 46804-2363
Phone
(260) 443-7300
NPI assigned
Feb 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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 06005287A IN Primary

Addresses

Primary practice location

4180 Sage Bluff Xing
Fort Wayne, IN 46804-2363

Mailing address

1407 Ely Ridge Pass
Fort Wayne, IN 46845-2364
Phone (260) 438-3146

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
06005287AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1497212369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 ELY RIDGE PASS",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468452364",
            "telephone_number": "260-438-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4180 SAGE BLUFF XING",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042363",
            "telephone_number": "260-443-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICK",
        "first_name": "ELIZABETH",
        "middle_name": "MERCEDES",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06005287A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.

Verify at the official NPI Registry.