Heather Ellis, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

024148-1 Issued in NY

Practice address

1367 Washington Ave
Suite 100
Albany, NY 12206-1043

Phone

(518) 438-7926

Fax

(518) 438-8364

NPI assigned

Jan 13, 2006

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516752000000",
    "number": "1093794489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 209",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-786-1667",
            "fax_number": "518-786-1954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1367 WASHINGTON AVE",
            "address_2": "SUITE 100",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122061043",
            "telephone_number": "518-438-7926",
            "fax_number": "518-438-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "HEATHER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2018-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024148-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00065768",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02517100",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "DD2273",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Akima S Ellis, RN
• Brian Ellis
• Colin Michael Ellis, M.D.
• Courtney Ann Ellis, MS OTR/L
• David A Ellis, M.D.
• Kelsey Ellis, CRNA
• Michael V Ellis, PH.D.
• Sherry J Ellis, HAIR SPECIALIST
• Curtis Ellison
• Jamie E Ellwood, OTR/L

• Physical Therapist in Albany, NY
• Providers in Albany, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2018; 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.