Emily Rose Ellerbrock, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP027858T Issued in WV

Practice address

255 Glendale Ave Ste 12
Sparks, NV 89431-5777

Phone

(775) 356-8181

NPI assigned

Oct 31, 2017

Last updated

Feb 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Drayer Physical Therapy Northern Ohio LLC

  • Physical Therapist
  • Dayton, OH
  • NPI 1871919969
  Medicare reassignment NPD
• Kuhn Enterprises LLC

  dba Premier Physical Therapy & Sports Performance

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1639537665
  NPD (past)

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1659883528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 GLENDALE AVE STE 12",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894315777",
            "telephone_number": "775-356-8181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6410 S Virginia St",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895111103",
            "country_code": "US",
            "telephone_number": "775-322-5757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7819 Waynetowne Blvd",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454242063",
            "country_code": "US",
            "telephone_number": "937-938-1583",
            "fax_number": "937-938-6723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLERBROCK",
        "first_name": "EMILY",
        "middle_name": "ROSE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "3657",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62472",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-5346",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT016868",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "CP027858T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Sparks, NV
• Providers in Sparks, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.