Individual provider Active NPI

Joel Everard, PT

  • Physical Therapist
  • Anchorage, AK
National Provider Identifier
1669589396
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1665 Issued in AK
Practice address
2704 E Tudor Rd
Anchorage, AK 99507-1136
Phone
(907) 561-5006
Fax
(907) 562-2398
NPI assigned
Aug 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 1665 AK
Physical Therapist 225100000X 1665 AK Primary

Addresses

Primary practice location

2704 E Tudor Rd
Anchorage, AK 99507-1136

Mailing address

2704 E Tudor Rd
Anchorage, AK 99507-1136
Phone (907) 561-5006

Other identifiers 1

IdentifierTypeStateIssuer
PT1665OtherAKLICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080507000028 AK Practitioner - Physical Therapist in Private Practice 5991884694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2704 E Tudor Rd
Anchorage, AK 99507-1136
Phone (907) 561-5006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1665AKMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Everard Physical Therapy, LLC CurrentSince Apr 1, 2008 Accepting new patients

Locations

2704 E Tudor Rd
Anchorage, AK 99507
Phone (907) 561-5006

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1669589396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071136",
            "telephone_number": "907-561-5006",
            "fax_number": "907-562-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071136",
            "telephone_number": "907-561-5006",
            "fax_number": "907-562-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERARD",
        "first_name": "JOEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AK",
            "license": "1665",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "PT1665",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.