Organization Active NPI

Elevated PT LLC

  • Physical Therapist
  • League City, TX
National Provider Identifier
1861172017
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ELEVATED PT LLC
Practice address
205 W Saunders St
League City, TX 77573-3831
Phone
(832) 410-9180
NPI assigned
Jul 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Authorized official

Name
Camaron Elizabeth BurneyNPI 1659904209
Title
Physical Therapist, Owner
Phone
(409) 770-3265

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness CoachGroup: 193200000X MULTI-SPECIALTY GROUP 171400000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

205 W Saunders St
League City, TX 77573-3831

Mailing address

205 W Saunders St
League City, TX 77573-3831

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230906003352 TX Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7911361134 Receives reassigned benefits from 5 practitioners
Practice locations: League City, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1861172017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W SAUNDERS ST",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W SAUNDERS ST",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775733831",
            "telephone_number": "832-410-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATED PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "BURNEY",
        "authorized_official_first_name": "CAMARON",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "409-770-3265"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in League City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.