Active NPI
Elizabeth Mudd, DPT
- Physical Therapist
- Lebanon, KY
National Provider Identifier
1578148409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 005917
- Practice address
- 727 W Main St
Lebanon, KY 40033-1838 - Phone
- (270) 321-4329
- NPI assigned
- Mar 11, 2021
- Last updated
- Mar 11, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 005917 | KY | Primary |
Addresses
Primary practice location
727 W Main St
Lebanon, KY 40033-1838
Mailing address
2230 Horan LN
Springfield, KY 40069-8904
Phone (859) 940-0411
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
| License | State | Type | Specialty |
|---|---|---|---|
| 005917 | KY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1578148409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2230 HORAN LN",
"city": "SPRINGFIELD",
"state": "KY",
"postal_code": "400698904",
"telephone_number": "859-940-0411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "727 W MAIN ST",
"city": "LEBANON",
"state": "KY",
"postal_code": "400331838",
"telephone_number": "270-321-4329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUDD",
"first_name": "ELIZABETH",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-11",
"last_updated": "2021-03-11",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KY",
"license": "005917",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lebanon, KY
- Eric Michael Mooney, MPT
- Laura S Moore, LCSW
- Moore's Therapy, LLC (Moore Pediatric Therapy)
- Anne C Morley, APRN
- Morning Star Surgical Services PLLC
- Jennifer B Mullins, A.R.N.P.
- My Extended Family, LLC
- One Cross Community, Inc.
- One Cross Health Clinic, Inc. (One Cross Medical Clinic)
- Karen H Orberson
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.