Individual provider Active NPI

Danielle Ekovich, PTA

  • Physical Therapy Assistant
  • Chesterton, IN
National Provider Identifier
1700963543
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06003228A Issued in IN
Practice address
1120 S Calumet Rd Ste 3
Chesterton, IN 46304-3286
Phone
(219) 983-9675
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06003228A IN Primary

Addresses

Primary practice location

1120 S Calumet Rd Ste 3
Chesterton, IN 46304-3286

Mailing address

1120 S Calumet Rd Ste 3
Chesterton, IN 46304-3286
Phone (219) 983-9675

Other identifiers 1

IdentifierTypeStateIssuer
200812210OtherINFIRST STEPS PROVIDER

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
06003228AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396915200000",
    "number": "1700963543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S CALUMET RD STE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043286",
            "telephone_number": "219-983-9675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S CALUMET RD STE 3",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463043286",
            "telephone_number": "219-983-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKOVICH",
        "first_name": "DANIELLE",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06003228A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST STEPS PROVIDER",
            "identifier": "200812210",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterton, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.