Ashley Michelle Ellison, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A776 Issued in AR

Practice address

207 W Conway St.
Benton, AR 72015

Phone

(501) 778-4861

Fax

(501) 776-5777

NPI assigned

Sep 18, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ms. Ashley Michelle Fee Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1073949467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 W CONWAY ST.",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "72015",
            "telephone_number": "501-778-4861",
            "fax_number": "501-776-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W CONWAY ST.",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "72015",
            "telephone_number": "501-778-4861",
            "fax_number": "501-776-5777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "ASHLEY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199525721",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COTA LIC #",
            "identifier": "OT-A776",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "FEE",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "COTA/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapy Assistant in Benton, AR
• Providers in Benton, AR by specialty
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.