Mark Bryan Ellis, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTR567 Issued in AR

Practice address

9601 Interstate 630 Exit 7
Little Rock, AR 72205-7202

Phone

(501) 202-7598

NPI assigned

Nov 3, 2008

Sex

Male

Sole proprietor

Yes

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

Enrolled in AR

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Arkansas for Medical SciencesGroup PAC ID 4082528955, 1,159 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016
  Medicare reassignment Care Compare group NPD
• University of Arkansas for Medical Sciences

  • Family Medicine Physician
  • El Dorado, AR
  • NPI 1023795051
  NPD

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225670400000",
    "number": "1003069147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 LORENE ST",
            "city": "AUSTIN",
            "state": "AR",
            "postal_code": "720079137",
            "telephone_number": "501-605-8113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 INTERSTATE 630 EXIT 7",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057202",
            "telephone_number": "501-202-7598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MARK",
        "middle_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-03",
        "last_updated": "2008-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Ellis, MD
• Elizabeth Kay Ellis, APRN
• Joshua C Ellis, MD, MPH
• Kaitlyn Ellis
• Lee Whetstone Ellis, LCSW
• Rodney Ellis, OBHP
• William Patrick Ellis, PA-C
• Brent Ellison, LPC
• Dale Alicia Ellison, MD
• Destiny Ellison

• Occupational Therapist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.