Active NPI
Alicia Eileen Derr, DPT
- Physical Therapist
- Ephrata, PA
National Provider Identifier
1992465702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT027969
- Practice address
- 169 Martin Ave
Ephrata, PA 17522-1724 - Phone
- (717) 733-0311
- NPI assigned
- Dec 20, 2021
- 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 | PT027969 | PA | Primary |
Addresses
Primary practice location
169 Martin Ave
Ephrata, PA 17522-1724
Mailing address
6 Myrtlewood CT
Lancaster, PA 17603-9209
Phone (570) 412-0967
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT027969 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639958400000",
"number": "1992465702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 MYRTLEWOOD CT",
"city": "LANCASTER",
"state": "PA",
"postal_code": "176039209",
"telephone_number": "570-412-0967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 MARTIN AVE",
"city": "EPHRATA",
"state": "PA",
"postal_code": "175221724",
"telephone_number": "717-733-0311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DERR",
"first_name": "ALICIA",
"middle_name": "EILEEN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-12-20",
"last_updated": "2021-12-20",
"certification_date": "2021-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT027969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ephrata, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.