Active NPI
Janel Culbertson
- Physical Therapist
- Peoria, IL
National Provider Identifier
1548766108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.023484
- Practice address
- 2338 W Van Winkle Way
Peoria, IL 61615 - Phone
- (309) 693-9189
- NPI assigned
- Apr 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501017339 | MI | |
| Physical Therapist | 225100000X | 070.023484 | IL | Primary |
Addresses
Primary practice location
2338 W Van Winkle Way
Peoria, IL 61615
Mailing address
411 Hamilton Blvd Ste 1908
Peoria, IL 61602-1146
Phone (309) 674-7874
Other practice location 1
36475 5 Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-4800
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070.023484 | IL | MD | Physical Therapist |
| 5501017339 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564099200000",
"number": "1548766108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "411 HAMILTON BLVD STE 1908",
"city": "PEORIA",
"state": "IL",
"postal_code": "616021146",
"telephone_number": "309-674-7874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2338 W VAN WINKLE WAY",
"city": "PEORIA",
"state": "IL",
"postal_code": "61615",
"telephone_number": "309-693-9189"
}
],
"practiceLocations": [
{
"address_1": "36475 5 Mile Rd",
"address_purpose": "LOCATION",
"city": "Livonia",
"state": "MI",
"postal_code": "481541971",
"country_code": "US",
"telephone_number": "734-655-4800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CULBERTSON",
"first_name": "JANEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-03",
"last_updated": "2019-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501017339",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.023484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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.