Active NPI
Amy Ellison, PT
- Physical Therapist
- Charleston, WV
National Provider Identifier
1033314893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 002632
- Practice address
- 1000 Association Dr
Charleston, WV 25311-1270 - Phone
- (304) 347-4372
- NPI assigned
- Jun 20, 2007
- 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 | 002632 | WV | Primary |
Addresses
Primary practice location
1000 Association Dr
Charleston, WV 25311-1270
Mailing address
306 Liverpool Rd
Reedy, WV 25270-9576
Phone (304) 927-2618
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 |
|---|---|---|---|
| 002632 | WV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033314893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "306 LIVERPOOL RD",
"city": "REEDY",
"state": "WV",
"postal_code": "252709576",
"telephone_number": "304-927-2618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 ASSOCIATION DR",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "253111270",
"telephone_number": "304-347-4372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "AMY",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "002632",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.