Active NPI
Judith Ann Ellis, LPT
- Physical Therapist
- Laredo, TX
National Provider Identifier
1104011949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1075695
- Practice address
- 1403 N. Seymour Ave
Laredo, TX 78040-8752 - Phone
- (956) 683-1155
- Fax
- (956) 683-1188
- NPI assigned
- Sep 13, 2007
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1075695 | TX | Primary |
Addresses
Primary practice location
1403 N. Seymour Ave
Laredo, TX 78040-8752
Mailing address
2806 Fountain Plaza Blvd
Edinburg, TX 78539-8031
Phone (956) 316-2224
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 |
|---|---|---|---|
| 1075695 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274227200000",
"number": "1104011949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2806 FOUNTAIN PLAZA BLVD",
"city": "EDINBURG",
"state": "TX",
"postal_code": "785398031",
"telephone_number": "956-316-2224",
"fax_number": "956-316-0445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1403 N. SEYMOUR AVE",
"city": "LAREDO",
"state": "TX",
"postal_code": "780408752",
"telephone_number": "956-683-1155",
"fax_number": "956-683-1188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "JUDITH",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-13",
"last_updated": "2010-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1075695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.