Active NPI
Elizabeth Hall, M.S.P.T.
- Physical Therapist
- San Diego, CA
National Provider Identifier
1578615902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 29942
- Practice address
- 3020 Childrens Way
MC 5068
San Diego, CA 92123-4223 - Phone
- (858) 576-1700
- NPI assigned
- Jan 17, 2007
- 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 | PT 29942 | CA | Primary |
| Physical Therapist | 225100000X | 2305206702 | VA |
Addresses
Primary practice location
3020 Childrens Way
MC 5068
San Diego, CA 92123-4223
Mailing address
3020 Childrens Way
MC 5068
San Diego, CA 92123-4223
Phone (858) 576-1700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT 29942 | Other | CA | PHYSICAL THERAPIST |
| 2305206702 | Other | VA | PT |
Other names 1
- Ms. Elizabeth Taibe
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 |
|---|---|---|---|
| PT 29942 | CA | MD | Physical Therapist |
| 2305206702 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411430400000",
"number": "1578615902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3020 CHILDRENS WAY",
"address_2": "MC 5068",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234223",
"telephone_number": "858-576-1700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3020 CHILDRENS WAY",
"address_2": "MC 5068",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234223",
"telephone_number": "858-576-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "M.S.P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2014-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT 29942",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305206702",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPIST",
"identifier": "PT 29942",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT",
"identifier": "2305206702",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "TAIBE",
"prefix": "MS.",
"credential": "M.S.P.T.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.