Individual provider Active NPI

Elizabeth Ann Wellsandt, DPT

  • Physical Therapist
  • Palmer, AK
National Provider Identifier
1790016491
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2122 Issued in AK
Practice address
809 S Chugach St
Palmer, AK 99645-6605
Phone
(907) 746-4373
NPI assigned
Jan 19, 2010
Last updated
Jan 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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 2122 AK Primary

Addresses

Primary practice location

809 S Chugach St
Palmer, AK 99645-6605

Mailing address

89146 564 Ave
Hartington, NE 68739-6090
Phone (402) 640-4261

Other names 1

  • Elizabeth Ann Heine Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2122AKMDPharmacist
3872NMMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chugach Physical Therapy Inc Physical Therapist CurrentSince Mar 27, 2012 Accepting new patients
Excel Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients
Excel Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients
Alaska Physical Therapy Specialists, LLC Physical Therapist PastSince May 17, 2016 Accepting new patients

Locations

2740 Lake Otis Pkwy
Anchorage, AK 99508
Phone (907) 743-3310

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": "1263859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263859200000",
    "number": "1790016491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89146 564 AVE",
            "city": "HARTINGTON",
            "state": "NE",
            "postal_code": "687396090",
            "telephone_number": "402-640-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 S CHUGACH ST",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996456605",
            "telephone_number": "907-746-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLSANDT",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-19",
        "last_updated": "2010-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "2122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "HEINE",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Palmer, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; 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.