Lisa Ellis, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5090 Issued in SC

Practice address

197 Piedmont Blvd Ste 205
Rock Hill, SC 29732-1846

Phone

(803) 639-8066

Fax

(803) 366-7755

NPI assigned

Sep 17, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Comprehab LLC

  • Physical Therapist
  • Gastonia, NC
  • NPI 1407932775

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1194151555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 COURT DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541478",
            "telephone_number": "704-824-7800",
            "fax_number": "704-824-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 PIEDMONT BLVD STE 205",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321846",
            "telephone_number": "803-639-8066",
            "fax_number": "803-366-7755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2110 Ben Craig Dr",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282622301",
            "country_code": "US",
            "telephone_number": "704-595-9363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2110 Ben Craig Dr",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282622301",
            "country_code": "US",
            "telephone_number": "704-595-9363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LISA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "8079",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "5090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Lynn Ellington, LPN
• Larry Elliott Jr., PTA
• Madison Elliott
• Alexis Taylor Ellis, RBT
• Charles Wayne Ellis, CACI, MAC
• Shanelle Elmore
• Linda A. Elrod, CRNA
• Shannon Leigh Ely, LPTA
• Embrace Clinical Services LLC
• Empower

• Occupational Therapist in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.