Individual provider Active NPI

Elizabeth Campbell, DPT

  • Physical Therapist
  • New London, CT
National Provider Identifier
1497256937
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13823 Issued in CT
Practice address
635 Broad Street
New London, CT 06320
Phone
(860) 447-8558
Fax
(860) 447-4552
NPI assigned
Feb 21, 2018
Last updated
Feb 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305213259 VA
Physical Therapist 225100000X 1302073 TX
Physical Therapist 225100000X 13823 CT Primary

Addresses

Primary practice location

635 Broad Street
New London, CT 06320

Mailing address

47 N Main St
West Hartford, CT 06107-1926
Phone (860) 409-4595

Other practice location 1

5871 Harbour View Blvd
Suffolk, VA 23435-3669
Phone (757) 632-3622

Other practice location 2

12997 Nettles Dr
Newport News, VA 23602-6913
Phone (757) 249-8880

Other names 1

  • Elizabeth Miller Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, VA, CT3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20181128000001 SC Practitioner - Physical Therapist in Private Practice 5991049231 Reassigns benefits to 2 organizations
I20201006002021 VA Practitioner - Physical Therapist in Private Practice 5991049231 Reassigns benefits to 1 organization
I20230105001117 CT Practitioner - Physical Therapist in Private Practice 5991049231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anb-Ptsma Holdings IncGroup PAC ID 4789572926, 190 clinicians

Practice addresses (Care Compare)

635 Broad St
New London, CT 06320-2543
Phone (860) 447-8558

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13823CTMDPhysical Therapist
1302073TXMDPhysical Therapist
2305213259VAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy - South Carolina, LLC Physical Therapist CurrentSince Nov 25, 2019 Accepting new patients
Drayer Physical Therapy-South Carolina, LLC Physical Therapist CurrentSince Nov 25, 2019 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Sep 9, 2020 Accepting new patients
Tidewater Physical Therapy, LLC Physical Therapist CurrentSince Sep 9, 2020 Accepting new patients
Anb-Ptsma Holdings, Inc. Physical Therapist CurrentSince Dec 19, 2022 Accepting new patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2018 Accepting new patients
Drayer Physical Therapy-South Carolina, LLC Physical Therapist Current Accepting new patients
RSFH - Ati Physical Therapy, LLC Physical Therapist CurrentSince Sep 1, 2018 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

635 Broad St
New London, CT 06320
Phone (860) 447-8558

103 E Main St
Unit C
Plainville, CT 06062
Phone (860) 517-8885

47 N Main St
West Hartford, CT 06107
Phone (860) 409-4595

790 Remington Blvd
Bolingbrook, IL 60440

33299 Collection Ctr Dr
Chicago, IL 60693

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

130 Forum Dr
Ste 13
Columbia, SC 29229
Phone (803) 509-6880

7585 Saint Andrews Rd
Irmo, SC 29063
Phone (803) 749-5031

2070 Northbrook Blvd
Ste A9
North Charleston, SC 29406
Phone (843) 377-0268

9241 University Blvd
Ste B1
North Charleston, SC 29406
Phone (843) 414-1140

10128 W Broad St
Bldg Iii
Glen Allen, VA 23060
Phone (804) 217-9210

1745 Camelot Dr
Ste 100
Virginia Beach, VA 23454
Phone (757) 496-2300

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1497256937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 N MAIN ST",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071926",
            "telephone_number": "860-409-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 BROAD STREET",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "860-447-8558",
            "fax_number": "860-447-4552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5871 Harbour View Blvd",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234353669",
            "country_code": "US",
            "telephone_number": "757-632-3622",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12997 Nettles Dr",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236026913",
            "country_code": "US",
            "telephone_number": "757-249-8880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-21",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305213259",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1302073",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "13823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "MILLER",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.