Active NPI
Marcia B Ellis, COTA
- Occupational Therapist
- Palm Harbor, FL
National Provider Identifier
1063553279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11525
- Practice address
- 34921 US Highway 19 N
Palm Harbor, FL 34684-1969 - Phone
- (727) 573-2747
- NPI assigned
- Feb 9, 2007
- Last updated
- Apr 2, 2012
- 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 Therapist | 225X00000X | 11525 | FL | Primary |
Addresses
Primary practice location
34921 US Highway 19 N
Palm Harbor, FL 34684-1969
Mailing address
1682 Blue Ribbon Blvd
Deland, FL 32724-8002
Phone (386) 736-2025
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 |
|---|---|---|---|
| 11525 | FL | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333324800000",
"number": "1063553279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1682 BLUE RIBBON BLVD",
"city": "DELAND",
"state": "FL",
"postal_code": "327248002",
"telephone_number": "386-736-2025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34921 US HIGHWAY 19 N",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346841969",
"telephone_number": "727-573-2747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "MARCIA",
"middle_name": "B",
"name_prefix": "Ms.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-09",
"last_updated": "2012-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "11525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Harbor, FL
- Ekallevig Transport
- Christy Jeanne Elder, RMHCI
- Element Spine and Wellness LLC
- Elite Health Systems of Palm Harbor (Palm Harbor Physicians Walk In Clinic)
- Elizabeth Linder DDS PA (Palm Harbor Periodontics)
- Yael Y. Ellis, M.D.
- Lydia Tarek Youssef Elsaid
- Eman FNP PLLC (Health Above All)
- Emotive Wellness Center
- Empath Home Health LLC (Empath Home Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.