Individual provider Active NPI

Ellen Welter, P.T.

  • Physical Therapist
  • Western Springs, IL
National Provider Identifier
1750677340
Registry record updated Apr 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
070018440 Issued in IL
Practice address
814 Hillgrove Ave
Western Springs, IL 60558-1439
Phone
(708) 505-3900
Fax
(708) 505-4647
NPI assigned
Jun 22, 2011
Last updated
Apr 3, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2014

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 070018440 IL Primary

Addresses

Primary practice location

814 Hillgrove Ave
Western Springs, IL 60558-1439

Mailing address

814 Hillgrove Ave
Western Springs, IL 60558-1439
Phone (708) 505-3900

Other identifiers 1

IdentifierTypeStateIssuer
070018440MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110801000719 IL Practitioner - Physical Therapist in Private Practice 8123297546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarity Physical Therapy and Wellness Center LLCGroup PAC ID 4082847041, 7 clinicians

Practice addresses (Care Compare)

814 Hillgrove Ave
Western Springs, IL 60558-1439
Phone (708) 505-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070018440ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
DX Medical and Physical Therapy Clinic LTD PastSince Mar 1, 2010 Accepting new patients
DX Physical Therapy & Rehabilitation, LTD. Past Accepting new patients
Flexeon Rehabilitation of Frankfort LLC Physical Therapist Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1750677340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 HILLGROVE AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581439",
            "telephone_number": "708-505-3900",
            "fax_number": "708-505-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 HILLGROVE AVE",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581439",
            "telephone_number": "708-505-3900",
            "fax_number": "708-505-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELTER",
        "first_name": "ELLEN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070018440",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Western Springs, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.