Active NPI
Ilene Simone Embrack, LMT
- Mechanotherapist
- Springfield, OH
National Provider Identifier
1992935654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- 33.015665
- Practice address
- 7585 Wrenview Dr
Springfield, OH 45502-8412 - Phone
- (937) 831-6555
- Fax
- (937) 964-8435
- NPI assigned
- Jul 16, 2009
- 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 |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | 33.015665 | OH | Primary |
Addresses
Primary practice location
7585 Wrenview Dr
Springfield, OH 45502-8412
Mailing address
7585 Wrenview Dr
Springfield, OH 45502-8412
Phone (937) 831-6555
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 |
|---|---|---|---|
| 33.015665 | OH | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424736000000",
"number": "1992935654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7585 WRENVIEW DR",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455028412",
"telephone_number": "937-831-6555",
"fax_number": "937-964-8435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7585 WRENVIEW DR",
"city": "SPRINGFIELD",
"state": "OH",
"postal_code": "455028412",
"telephone_number": "937-831-6555",
"fax_number": "937-964-8435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMBRACK",
"first_name": "ILENE",
"middle_name": "SIMONE",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-07-16",
"last_updated": "2015-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "OH",
"license": "33.015665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.