Individual provider Active NPI

Chelsea Elder

  • Pediatric Occupational Therapist
  • Fort Wayne, IN
National Provider Identifier
1679930549
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
31006099A Issued in IN
Practice address
4935 Hillegas Rd Ste 200
Fort Wayne, IN 46818-1934
Phone
(260) 338-1241
NPI assigned
Jan 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 31006099A IN Primary

Addresses

Primary practice location

4935 Hillegas Rd Ste 200
Fort Wayne, IN 46818-1934

Mailing address

4935 Hillegas Rd Ste 200
Fort Wayne, IN 46818-1934
Phone (260) 338-1241

Other practice location 1

1353 E Main St
Brownsburg, IN 46112-1433
Phone (317) 294-5242

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

LicenseStateTypeSpecialty
31006099AINMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
K1DS Count Therapy, LLC PastSince Feb 2, 2020 Accepting new patients
Possibilities Northeast, LLC. PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

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": "1453593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679930549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4935 HILLEGAS RD STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468181934",
            "telephone_number": "260-338-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4935 HILLEGAS RD STE 200",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468181934",
            "telephone_number": "260-338-1241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1353 E Main St",
            "address_purpose": "LOCATION",
            "city": "Brownsburg",
            "state": "IN",
            "postal_code": "461121433",
            "country_code": "US",
            "telephone_number": "317-294-5242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELDER",
        "first_name": "CHELSEA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IN",
            "license": "31006099A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.