Individual provider Active NPI

Elizabeth R Rolston, PT, DPT

  • Physical Therapist
  • Traverse City, MI
National Provider Identifier
1679062954
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501301719 Issued in MI
Practice address
629 W Eleventh St
Traverse City, MI 49684-3149
Phone
(734) 660-4976
Fax
(231) 202-2339
NPI assigned
May 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501301719 MI Primary

Addresses

Primary practice location

629 W Eleventh St
Traverse City, MI 49684-3149

Mailing address

629 W Eleventh St
Traverse City, MI 49684-3149
Phone (734) 660-4976

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1679062954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 W ELEVENTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843149",
            "telephone_number": "734-660-4976",
            "fax_number": "231-202-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 W ELEVENTH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496843149",
            "telephone_number": "734-660-4976",
            "fax_number": "231-202-2339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLSTON",
        "first_name": "ELIZABETH",
        "middle_name": "R",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-02",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501301719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.