Individual provider Active NPI

Chanel Irene Marie Ebert, PT, DPT

  • Physical Therapist
  • Willow, AK
National Provider Identifier
1922449255
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
188490 Issued in AK
Practice address
24413 W Willow Creek Pkwy
Willow, AK 99688
Phone
(785) 456-4582
NPI assigned
Jul 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 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 188490 AK Primary

Addresses

Primary practice location

24413 W Willow Creek Pkwy
Willow, AK 99688

Mailing address

PO Box 924
Willow, AK 99688-0924
Phone (785) 456-4582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

24413 W Willow Creek Pkwy
Willow, AK 99688
Phone (907) 210-2239

PO Box
Suite 924
Willow, AK 99688

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41213CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northbound Physical Therapy, LLC CurrentSince Jun 8, 2025 Accepting new patients
Select Physical Therapy Holdings Inc CurrentSince Nov 15, 2022 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist Current Accepting new patients
Select Physical Therapy Holdings, Inc. CurrentSince Nov 15, 2022 Accepting new patients

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": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1922449255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 924",
            "city": "WILLOW",
            "state": "AK",
            "postal_code": "996880924",
            "telephone_number": "785-456-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24413 W WILLOW CREEK PKWY",
            "city": "WILLOW",
            "state": "AK",
            "postal_code": "99688",
            "telephone_number": "785-456-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERT",
        "first_name": "CHANEL",
        "middle_name": "IRENE MARIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2025-06-02",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "188490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willow, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.