Individual provider Active NPI

Emily Ellerbrock, PT, DPT

  • Physical Therapist
  • Lima, OH
National Provider Identifier
1912711243
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT021523 Issued in OH
Practice address
3477 S Dixie Hwy
Lima, OH 45804-3706
Phone
(567) 356-4385
NPI assigned
Feb 6, 2025
Last updated
Feb 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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 PT021523 OH Primary

Addresses

Primary practice location

3477 S Dixie Hwy
Lima, OH 45804-3706

Mailing address

3477 S Dixie Hwy
Lima, OH 45804-3706
Phone (567) 356-4385

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250218000801 OH Practitioner - Physical Therapist in Private Practice 6709306053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Toledo College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back on Track Therapy and Wellness, LLCGroup PAC ID 0749524775, 4 clinicians

Practice addresses (Care Compare)

3477 S Dixie Hwy
Lima, OH 45804-3706
Phone (567) 356-4385

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT021523OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back on Track Therapy and Wellness, LLC Physical Therapist CurrentSince Feb 6, 2025 Accepting new patients

Locations

3477 S Dixie Hwy
Lima, OH 45804
Phone (419) 224-2820

4030 Allentown Rd
Lima, OH 45807
Phone (419) 231-3665

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1912711243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3477 S DIXIE HWY",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458043706",
            "telephone_number": "567-356-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3477 S DIXIE HWY",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458043706",
            "telephone_number": "567-356-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERBROCK",
        "first_name": "EMILY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT021523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.