Ellen R Haverstick, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2484 Issued in AR

Practice address

1065 Clayton St
Suite 9
Conway, AR 72032-4329

Phone

(501) 328-5878

Fax

(501) 336-0119

NPI assigned

Jun 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ellen Haverstick, PLLC 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ellen Haverstick, PLLC

  • Physical Therapist
  • Conway, AR
  • NPI 1134138670

  AR, Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Maumelle Physical Therapy, Inc.

  • Physical Therapist
  • Conway, AR
  • NPI 1487615779
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1720029655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1168",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720331168",
            "telephone_number": "501-733-3969",
            "fax_number": "501-336-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 CLAYTON ST",
            "address_2": "SUITE 9",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324329",
            "telephone_number": "501-328-5878",
            "fax_number": "501-336-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERSTICK",
        "first_name": "ELLEN",
        "middle_name": "R",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "2484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rimsha Hasan, M.D.
• Elizabeth Haskett, QBHP-D
• Mary Katherine Hassen
• Antanette Hatchett, RECOVERY ASSISTANT
• Jason Scott Havard, DDS
• Kristen Nicole Hawkins, ST
• Griffin Hawthorne, ATC
• Latoya Haynes, RECOVERY ASSISTANT
• Leigh Haynes
• Bradley Hays, LPC

• All providers in Conway, AR
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.