Active NPI
Ellen Kroog Donald, PT
- Physical Therapist
- Fort Myers, FL
National Provider Identifier
1689944118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT19135
- Practice address
- 14391 Metropolis Ave
Suite 101
Fort Myers, FL 33912-4423 - Phone
- (239) 561-2778
- NPI assigned
- Dec 30, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | PT19135 | FL | Primary |
Addresses
Primary practice location
14391 Metropolis Ave
Suite 101
Fort Myers, FL 33912-4423
Mailing address
16610 Willow Point CT
Alva, FL 33920-3162
Phone (239) 850-7183
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT19135 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hale Therapy Service Inc | Physical Therapist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652659200000",
"number": "1689944118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16610 WILLOW POINT CT",
"city": "ALVA",
"state": "FL",
"postal_code": "339203162",
"telephone_number": "239-850-7183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14391 METROPOLIS AVE",
"address_2": "SUITE 101",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339124423",
"telephone_number": "239-561-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONALD",
"first_name": "ELLEN",
"middle_name": "KROOG",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-30",
"last_updated": "2022-05-16",
"certification_date": "2022-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT19135",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.