Active NPI
Cherie A Ebel, PT
- Physical Therapist
- Roanoke, VA
National Provider Identifier
1881805612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2305211458
- Practice address
- 4533 Brambleton Ave
Roanoke, VA 24018-3436 - Phone
- (540) 772-8022
- Fax
- (540) 772-0294
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305211458 | VA | Primary |
Addresses
Primary practice location
4533 Brambleton Ave
Roanoke, VA 24018-3436
Mailing address
4533 Brambleton Ave
Roanoke, VA 24018-3436
Phone (540) 772-8022
Other practice location 1
7712 Old Canton Rd
Madison, MS 39110
Phone (601) 853-9588
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09014760 | Medicaid | MS |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Medical Group of Mississippi LLC | Past | Accepting new patients | |
| Professional Therapy Services Inc | Physical Therapist | Past | Accepting new patients |
| Premier Medical Group of Mississippi LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Clinic/Center
- Jackson, MS
- NPI 1548219884
-
- Clinic/Center
- Kosciusko, MS
- NPI 1790827038
-
- Physical Therapist
- Tuscaloosa, AL
- NPI 1851462485
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519344000000",
"number": "1881805612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4533 BRAMBLETON AVE",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240183436",
"telephone_number": "540-772-8022",
"fax_number": "540-772-0294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4533 BRAMBLETON AVE",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240183436",
"telephone_number": "540-772-8022",
"fax_number": "540-772-0294"
}
],
"practiceLocations": [
{
"address_1": "7712 Old Canton Rd",
"address_purpose": "LOCATION",
"city": "Madison",
"state": "MS",
"postal_code": "39110",
"country_code": "US",
"telephone_number": "601-853-9588",
"fax_number": "601-714-3414",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EBEL",
"first_name": "CHERIE",
"middle_name": "A",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2018-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305211458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09014760",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.