Active NPI
Emily White, DPT
- Physical Therapist
- Bloomington, IL
National Provider Identifier
1649729625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 05012100A
- Practice address
- 19 Lexis CT
Bloomington, IL 61704-4814 - Phone
- (309) 824-7297
- NPI assigned
- Oct 1, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-4534 | ID | |
| Physical Therapist | 225100000X | 05012100A | IN | Primary |
Addresses
Primary practice location
19 Lexis CT
Bloomington, IL 61704-4814
Mailing address
19 Lexis CT
Bloomington, IL 61704-4814
Phone (309) 824-7297
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-4534 | ID | MD | Physical Therapist |
| 05012100A | IN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475280000000",
"number": "1649729625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 LEXIS CT",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617044814",
"telephone_number": "309-824-7297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 LEXIS CT",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617044814",
"telephone_number": "309-824-7297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "EMILY",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-01",
"last_updated": "2016-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-4534",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05012100A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.