Mary Elizabeth Daubert

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160.003001 Issued in IL

Practice address

5615 US Highway 45 N
Vienna, IL 62995-2002

Phone

(609) 845-7201

NPI assigned

Jul 24, 2012

Last updated

Jul 24, 2012By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343088000000",
    "number": "1770839052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 US HIGHWAY 45 N",
            "city": "VIENNA",
            "state": "IL",
            "postal_code": "629952002",
            "telephone_number": "609-845-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 US HIGHWAY 45 N",
            "city": "VIENNA",
            "state": "IL",
            "postal_code": "629952002",
            "telephone_number": "609-845-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUBERT",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160.003001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Michael Corzine, LCSW
• County of Johnson (Johnson County Ambulance Service)
• Sherrie Leann Crabb, MS, QMHP
• Sharon Craig, BSE, MHP
• Martha Jane Crawford, LCSW
• Alfonso Chy David, M.D.
• Monique Davis, BS, LPN, MHP
• Ansley Daymon, BS, MHP
• Jennifer Ann Diers, LPN, MHP
• Connie Larae Duncan, LCSW

• Physical Therapy Assistant in Vienna, IL
• Providers in Vienna, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.