Active NPI
Caleb Martin Elder, DPT
- Physical Therapist
- Avondale, AZ
National Provider Identifier
1689191512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- LPT-013263
- Practice address
- 765 N 114TH Ave Ste 101
Avondale, AZ 85323-5003 - Phone
- (602) 933-7778
- Fax
- (602) 933-4296
- NPI assigned
- Aug 22, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | LPT-013263 | Primary |
Addresses
Primary practice location
765 N 114TH Ave Ste 101
Avondale, AZ 85323-5003
Mailing address
2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-7761
Phone (602) 933-1813
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 303005 | Medicaid | AZ |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phoenix Children's Hospital | Past | Accepting new patients |
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.
-
dba Phoenix Children's Medical Group
- Pediatrics Physician
- Phoenix, AZ
- NPI 1922112044
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657584000000",
"number": "1689191512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2108 E THOMAS RD STE 130",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850167761",
"telephone_number": "602-933-1813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "765 N 114TH AVE STE 101",
"city": "AVONDALE",
"state": "AZ",
"postal_code": "853235003",
"telephone_number": "602-933-7778",
"fax_number": "602-933-4296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDER",
"first_name": "CALEB",
"middle_name": "MARTIN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-22",
"last_updated": "2022-07-12",
"certification_date": "2022-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": "LPT-013263",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "303005",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Avondale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.