Elicia Larshney Anderson

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

22 Bermuda Greens Ave
Ponte Vedra, FL 32081-4370

Phone

(904) 235-9722

NPI assigned

Jun 29, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Prevail Therapy Services, LLC

  • Physical Therapist
  • Ponte Vedra, FL
  • NPI 1073261897
  NPD (past)
• Prevail Therapy Services, LLC

  • Early Intervention Provider Agency
  • Ponte Vedra, FL
  • NPI 1528327129
  NPD (past)

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1992092878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 BERMUDA GREENS AVE",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320814370",
            "telephone_number": "904-235-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 BERMUDA GREENS AVE",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320814370",
            "telephone_number": "904-235-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ELICIA",
        "middle_name": "LARSHNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Therapist in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.