Individual provider Active NPI

Elizabeth Joy Hadley, PT

  • Physical Therapist
  • Lodi, CA
National Provider Identifier
1689736597
Registry record updated Jul 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT18978 Issued in CA
Practice address
222 W Pine St
Lodi, CA 95240-2020
Phone
(209) 368-1009
Fax
(209) 368-1024
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2011

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 PT18978 CA Primary

Addresses

Primary practice location

222 W Pine St
Lodi, CA 95240-2020

Mailing address

222 W Pine St
Lodi, CA 95240-2020
Phone (209) 368-1009

Other identifiers 1

IdentifierTypeStateIssuer
650018738OtherCARAILROAD MEDICARE PTAN

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

State licenses

LicenseStateTypeSpecialty
PT18978CAMDPhysical Therapist
18978CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Senior Rehabilitation Services, Inc. Physical Therapist Past Accepting new patients
Innovative Senior Rehabilitation Services, Inc. Physical Therapist PastSince Apr 12, 2005 Accepting new patients
Innovative Senior Rehabilitation Services Inc. Physical Therapist Past Accepting new patients

Organizations & group practices 3

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310256000000",
    "number": "1689736597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W PINE ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952402020",
            "telephone_number": "209-368-1009",
            "fax_number": "209-368-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W PINE ST",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952402020",
            "telephone_number": "209-368-1009",
            "fax_number": "209-368-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADLEY",
        "first_name": "ELIZABETH",
        "middle_name": "JOY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2011-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT18978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PTAN",
            "identifier": "650018738",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2011; 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.