Jacob Ellison, DPT

Primary specialty

Neurology Physical TherapistTaxonomy code 2251N0400X

License

05015247A Issued in IN

Practice address

3700 Washington Ave
Evansville, IN 47714-0541

Phone

(812) 485-5621

NPI assigned

Nov 8, 2023

Last updated

Nov 8, 2023By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1699401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1184498388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 ROSSMAY DR",
            "city": "WESTFIELD",
            "state": "IN",
            "postal_code": "460747931",
            "telephone_number": "317-809-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140541",
            "telephone_number": "812-485-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "JACOB",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-08",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "IN",
            "license": "05015247A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cedalia Amber Ellis, LSW
• Ebonique Ellis
• Savannah D Ellis, LPN
• Vickie Ellis
• Carla R Ellison, MS, CCC-SLP
• Michael Wayne Ellsperman, RPH
• Susan Ellsperman, MD
• Laura Lynn Ellsworth, MA, LMHC
• Haley Elpers, DPT
• Molly Elpers, RN

• Neurology Physical Therapist in Evansville, IN
• Providers in Evansville, IN by specialty
• Neurology Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.