Active NPI
Elyse Nicole Ackerly, COTA/L
- Occupational Therapy Assistant
- Wesley Chapel, FL
National Provider Identifier
1033849930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 17287
- Practice address
- 2370 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9214 - Phone
- (813) 733-6152
- NPI assigned
- Jun 14, 2022
- Last updated
- Jun 14, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 17287 | FL | Primary |
Addresses
Primary practice location
2370 Bruce B Downs Blvd
Wesley Chapel, FL 33544-9214
Mailing address
8014 N 46TH St
Tampa, FL 33617-6902
Phone (605) 759-0768
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 |
|---|---|---|---|
| 17287 | FL | MD | General Care Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655164800000",
"number": "1033849930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8014 N 46TH ST",
"city": "TAMPA",
"state": "FL",
"postal_code": "336176902",
"telephone_number": "605-759-0768"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2370 BRUCE B DOWNS BLVD",
"city": "WESLEY CHAPEL",
"state": "FL",
"postal_code": "335449214",
"telephone_number": "813-733-6152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKERLY",
"first_name": "ELYSE",
"middle_name": "NICOLE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-14",
"last_updated": "2022-06-14",
"certification_date": "2022-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "17287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wesley Chapel, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.