Individual provider Active NPI

David J Elliff, PT

  • Physical Therapist
  • Glen Carbon, IL
National Provider Identifier
1891811071
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4802 S State Route 159
Glen Carbon, IL 62034-1904
Phone
(618) 288-4388
Fax
(618) 288-4927
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

4802 S State Route 159
Glen Carbon, IL 62034-1904

Mailing address

4802 S State Route 159
Glen Carbon, IL 62034-1904
Phone (618) 288-4388

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070712000115 IL Practitioner - Physical Therapist in Private Practice 0345340972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apex Physical Therapy, LLCGroup PAC ID 2264423458, 104 clinicians

Practice addresses (Care Compare)

1503 Lindell Blvd
Granite City, IL 62040-3837
Phone (618) 709-4125

Merit-based Incentive Payment System (MIPS)

Final score
76.03 of 100Reported as group
Quality
74.47
Improvement activities
40
Cost
66.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
070.014964ILMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince May 30, 2018 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist CurrentSince May 30, 2018 Accepting new patients
Apex Physical Therapy, LLC Physical Therapist PastSince May 30, 2018 Accepting new patients
Granite City Orthopedic Physicians Company LLC Past Accepting new patients

Locations

1095 Belt Line Rd
Ste 400
Collinsville, IL 62234
Phone (618) 477-8550

4955 S State Route 159
Ste B
Glen Carbon, IL 62034
Phone (618) 288-4677

1503 Lindell Blvd
Granite City, IL 62040
Phone (618) 709-4125

15 Apex Dr
Highland, IL 62249
Phone (618) 441-0482

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891811071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 S STATE ROUTE 159",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341904",
            "telephone_number": "618-288-4388",
            "fax_number": "618-288-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 S STATE ROUTE 159",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341904",
            "telephone_number": "618-288-4388",
            "fax_number": "618-288-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIFF",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Carbon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.