Elizabeth Fackler, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4925 Issued in KY

Practice address

4610 Chamberlain LN
Louisville, KY 40241-1160

Phone

(502) 618-8200

Fax

(502) 618-8201

NPI assigned

Feb 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Elizabeth Allen Former name

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benchmark Physical Therapy of Ky LLCGroup PAC ID 0042577579, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Benchmark Physical Therapy of Ky LLC

  • Physical Therapist
  • Chattanooga, TN
  • NPI 1043734221

  KY, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Results-Ast JV, LLC

  • Physical Therapist
  • Franklin, TN
  • NPI 1780291948

  KY, Physical Therapist

  Medicare reassignment NPD
• Drayer Physical Therapy Kentucky LLC

  • Physical Therapist
  • Lexington, KY
  • NPI 1821430257

  KY

  Medicare reassignment
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  KY

  Medicare reassignment
• Drayer Physical Therapy Kentucky LLC

  • Physical Therapist
  • Richmond, KY
  • NPI 1003258443
  NPD
• Drayer Physical Therapy Kentucky LLC

  • Physical Therapist
  • Winchester, KY
  • NPI 1639511074
  NPD
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Louisville, KY
  • NPI 1609117811
  NPD (past)
• Apex Physical Therapy and Rehabilitation, PLLC

  • Physical Therapist
  • Louisville, KY
  • NPI 1649218306
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596067200000",
    "number": "1801930730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306393",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306393",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 CHAMBERLAIN LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402411160",
            "telephone_number": "502-618-8200",
            "fax_number": "502-618-8201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 Blankenbaker Pkwy",
            "address_2": "Suite 107",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402431894",
            "country_code": "US",
            "telephone_number": "502-253-0833",
            "fax_number": "502-253-0834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FACKLER",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "KY",
            "license": "004925",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "4925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER ID",
            "identifier": "000000484220",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY STATE LICENSE",
            "identifier": "KY4925",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "ALLEN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vilma C Fabre, M.D.
• Jacqueline Fabricius
• Benjamin Facer, MD
• Faces of Change LLC
• Debora Ann Faciane, MS, MFTA
• Jason Keith Fackler, ARNP
• Kevin Grant Fackler, TSW
• Margaret Fackler, APRN
• Steven Faddis, PA
• Daniel A. Fadel, DMD

• All providers in Louisville, KY
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.