Krista Ellis

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018424 Issued in MI

Practice address

30637 W 14 Mile Rd
Farmington Hills, MI 48334-1531

Phone

(248) 983-4780

NPI assigned

Sep 20, 2017

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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Total Care Therapy LLCGroup PAC ID 5890122816, 109 clinicians

Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Bay City, MI
  • NPI 1942829064
  Medicare reassignment Care Compare group
• Total Care Therapy LLC

  • Physical Therapist
  • Dublin, OH
  • NPI 1639717812

  MI

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1174032304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25350 KILDARE ST",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480335354",
            "telephone_number": "989-413-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30637 W 14 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483341531",
            "telephone_number": "248-983-4780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KRISTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gwyneth Ellis
• Harley Ellis
• Jasmine Ellis
• Karissa Ellis
• Kennae Ellis
• Kylee Ellis
• Lashawne Ellis
• Mary Ellis
• Matthew Joseph Ellis
• Nicole Ellis

• Physical Therapist in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; 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.