Natalie Ellis, LMT, PTA

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MASA3541 Issued in ID

Practice address

1625 W State St Ste 100
Boise, ID 83702-4003

Phone

(208) 336-0017

Fax

(208) 439-7657

NPI assigned

Aug 14, 2019

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Dupont Wellness PLLC

  • Physical Therapy Clinic/Center
  • Boise, ID
  • NPI 1861254278
  NPD
• Action Point Physical Therapy LLC

  • Rehabilitation Clinic/Center
  • Sandpoint, ID
  • NPI 1821502204
  NPD (past)

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1083260194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E BLUE TICK ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836427474",
            "telephone_number": "208-340-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 W STATE ST STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024003",
            "telephone_number": "208-336-0017",
            "fax_number": "208-439-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "NATALIE",
        "credential": "LMT, PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ID",
            "license": "MASA3541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "MASA3541",
            "state": "ID"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "genbook.com",
            "affiliation": "N",
            "endpointDescription": "booking system",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "scheduling",
            "address_1": "1625 W State St Ste 100",
            "city": "Boise",
            "state": "ID",
            "country_code": "US",
            "postal_code": "837024003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ryan Teall Elliott
• Cynthia Eorio Ellis, LCPC
• Lindsay Ellis, LCSW
• Logan Ellis
• Madeline Ellis, LPC
• Nathan Cody Ellis, LCPC
• Patricia Taylor Ellis, LMSW
• Staci Dawn Ellis, LMT
• Susie Ellis, CPM, LM
• Timothy J. Ellis, O.D.

• Massage Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.