Active NPI
Deanna Eldred, PT
- Physical Therapist
- Winslow, AZ
National Provider Identifier
1962457721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- J1-0002082
- Practice address
- 221 W Second St
Winslow, AZ 86047-3564 - Phone
- (928) 289-4378
- Fax
- (928) 289-5116
- NPI assigned
- May 23, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | J1-0002082 | DE | Primary |
Addresses
Primary practice location
221 W Second St
Winslow, AZ 86047-3564
Mailing address
PO Box 16019
Bellemont, AZ 86015-6019
Phone (302) 388-2644
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J1-0002082 | DE | MD | Physical Therapist |
| 8703 | MN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| High Desert Physical Therapy and Sports Rehabilitation, PLLC | Physical Therapist | Past | Accepting new patients |
| Chippewa Valley Physical Therapy SC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Physical Therapist
- Winslow, AZ
- NPI 1518937325
-
- Physical Therapist
- Chippewa Falls, WI
- NPI 1558375493
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962457721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16019",
"city": "BELLEMONT",
"state": "AZ",
"postal_code": "860156019",
"telephone_number": "302-388-2644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 W SECOND ST",
"city": "WINSLOW",
"state": "AZ",
"postal_code": "860473564",
"telephone_number": "928-289-4378",
"fax_number": "928-289-5116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDRED",
"first_name": "DEANNA",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DE",
"license": "J1-0002082",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winslow, AZ
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.