Elevate Therapy & Performance PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ELEVATE THERAPY & PERFORMANCE PC

Practice address

214 W Freeman St
Carbondale, IL 62901-2809

Phone

(812) 491-1307

Fax

(618) 549-0226

NPI assigned

Jan 8, 2020

Organization subpart

No

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

Authorized official

Name

Cody B Doerflein, DPT

Title

Owner

Phone

(618) 549-0225

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604880000000",
    "number": "1871133876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3276",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477313276",
            "telephone_number": "812-473-0181",
            "fax_number": "812-473-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 W FREEMAN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629012809",
            "telephone_number": "812-491-1307",
            "fax_number": "618-549-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE THERAPY & PERFORMANCE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A",
        "authorized_official_last_name": "DOERFLEIN",
        "authorized_official_first_name": "CODY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-549-0225",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "070024815",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abraham El-Sedfy, M.D.
• Samir Elabbadi
• Barb Grace Elam, LCPC
• David Allen Elam, PH.D.
• Elbert a Fasnacht II MD LTD
• Salman Mahmoud Elgharbawy, MD
• Labib Elkahwaji, MD
• Emilie Joann Emberton
• Empowerme Rehabilitation Illinois, LLC
• Richard Lan England, M.D.

• Physical Therapist in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.