Individual provider Active NPI

Ashley Ellison, OT

  • Occupational Therapist
  • Woodstock, GA
National Provider Identifier
1114673852
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT008341 Issued in GA
Practice address
1505 Stone Bridge Pkwy Ste 200
Woodstock, GA 30189-8282
Phone
(770) 926-9112
NPI assigned
Feb 22, 2022
Last updated
Nov 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT008341 GA Primary

Addresses

Primary practice location

1505 Stone Bridge Pkwy Ste 200
Woodstock, GA 30189-8282

Mailing address

1505 Stone Bridge Pkwy Ste 200
Woodstock, GA 30189-8282
Phone (770) 926-9112

Other practice location 1

2920 Ronald Reagan Blvd Ste 106
Cumming, GA 30041-7578
Phone (770) 887-0502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220228001930 GA Practitioner - Occupational Therapist in Private Practice 7618361056 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT008341GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC Occupational Therapist CurrentSince Dec 6, 2022 Accepting new patients
Pinnacle Orthopaedics & Sports Medicine Specialists LLC CurrentSince Dec 6, 2022 Accepting new patients
Empowerme Rehabilitation Georgia, LLC Occupational Therapist CurrentSince Nov 4, 2024 Accepting new patients

Locations

5610 Hampton Park Dr
Cumming, GA 30041
Phone (470) 866-5540

100 Greystone Power Blvd
Dallas, GA 30157
Phone (678) 453-5717

300 Tower Rd NE
Ste 100
Marietta, GA 30060
Phone (770) 499-9118

300 Tower Rd NE
Ste 101
Marietta, GA 30060
Phone (770) 218-0219

300 Tower Rd NE
Ste 200
Marietta, GA 30060
Phone (770) 427-5717

1505 Stone Bridge Pkwy
Ste 200
Woodstock, GA 30189
Phone (770) 926-6520

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1114673852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 STONE BRIDGE PKWY STE 200",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301898282",
            "telephone_number": "770-926-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 STONE BRIDGE PKWY STE 200",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301898282",
            "telephone_number": "770-926-9112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2920 Ronald Reagan Blvd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417578",
            "country_code": "US",
            "telephone_number": "770-887-0502",
            "fax_number": "770-887-0054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "ASHLEY",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT008341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.