NPIMap

Individual provider Active NPI

Yvonne L Elliott, P.T.

  • Physical Medicine & Rehabilitation Physician
  • Coeur D Alene, ID
National Provider Identifier
1992900245
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PT 2213 Issued in ID
Practice address
2448 N Merrit Creek Loop
Suite 2a
Coeur D Alene, ID 83814-4953
Phone
(208) 664-2901
Fax
(208) 667-9266
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PT 2213 ID Primary

Addresses

Primary practice location

2448 N Merrit Creek Loop
Suite 2a
Coeur D Alene, ID 83814-4953

Mailing address

2448 N Merrit Creek Loop
Suite 2a
Coeur D Alene, ID 83814-4953
Phone (208) 664-2901

Other identifiers 14

IdentifierTypeStateIssuer
82053495583814A009OtherTRIWEST/TRICARE
QMXPR0060660OtherMOLINA
DA3588OtherRAIL ROAD MEDICARE
32101OtherGROUP HEALTH
5003984OtherREGENCE MEDADVANTAGE
907605881MedicaidID
185598800OtherFEDERAL L&I
4746230001OtherIDMEDICARE-DME
88753OtherFIRST CHOICE
TD895OtherIDBLUE CROSS
000010175553OtherIDBLUE SHIELD
262004OtherWA L&I
82-0534955OtherSTATE INS FUND
82-0534955OtherSTERLING

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

LicenseStateTypeSpecialty
PT 2213IDMDPhysical Medicine & Rehabilitation Physician
021791NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
CRS Homebased Physical Therapy, P.C. PastSince Jun 5, 2004 Accepting new patients
Cda Hand Therapy & Healing Center PA Physical Medicine & Rehabilitation Past Accepting new patients
Pinnacle Physical Therapy and Sports Medicine, Inc PastSince Apr 1, 2007 Accepting new patients
Michele Rauer Physical Therapy Assistant, P.C. PastSince Nov 28, 2021 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": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1992900245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2448 N MERRIT CREEK LOOP",
            "address_2": "SUITE 2A",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144953",
            "telephone_number": "208-664-2901",
            "fax_number": "208-667-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 N MERRIT CREEK LOOP",
            "address_2": "SUITE 2A",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838144953",
            "telephone_number": "208-664-2901",
            "fax_number": "208-667-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "YVONNE",
        "middle_name": "L",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "ID",
            "license": "PT 2213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST/TRICARE",
            "identifier": "82053495583814A009",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "QMXPR0060660",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DA3588",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "32101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE MEDADVANTAGE",
            "identifier": "5003984",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "907605881",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL L&I",
            "identifier": "185598800",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-DME",
            "identifier": "4746230001",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CHOICE",
            "identifier": "88753",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "TD895",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010175553",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "262004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE INS FUND",
            "identifier": "82-0534955",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STERLING",
            "identifier": "82-0534955",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.