Individual provider Active NPI

Rachel Lynn Annette Ellis, PHYSICAL THERAPIST

  • Physical Therapist
  • Orlando, FL
National Provider Identifier
1205976453
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT40347 Issued in FL
Practice address
4401 E Colonial Dr Ste 107
Orlando, FL 32803-5200
Phone
(407) 898-5060
Fax
(407) 898-5185
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070-012829 IL
Physical Therapist 225100000X PT40347 FL Primary

Addresses

Primary practice location

4401 E Colonial Dr Ste 107
Orlando, FL 32803-5200

Mailing address

4401 E Colonial Dr Ste 107
Orlando, FL 32803-5200
Phone (407) 898-5060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140523000204 IL Practitioner - Physical Therapist in Private Practice 6204059066 Reassigns benefits to 2 organizations
I20231025000115 FL Practitioner - Physical Therapist in Private Practice 6204059066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
83.26 of 100Reported as group
Quality
86.58
Improvement activities
40
Cost
68.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT40347FLMDPhysical Therapist
070-012829ILMDPhysical Therapist

Practice roles (5 of 6)

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Nov 21, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Sep 18, 2023 Accepting new patients
Decatur Orthopedic Center, LLC CurrentSince May 13, 2019 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Sep 18, 2023 Accepting new patients
Comprehensive Therapeutics LTD Physical Therapist CurrentSince Nov 21, 2022 Accepting new patients

Locations

1145 Arbor Dr
Decatur, IL 62526
Phone (217) 247-7509

1800 E Lake Shore Dr
Ste 3
Decatur, IL 62521

1015 Oconor Ave
La Salle, IL 61301
Phone (224) 616-5446

104 E Ashland Ave
Mt Zion, IL 62549
Phone (217) 864-2665

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1205976453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 E COLONIAL DR STE 107",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035200",
            "telephone_number": "407-898-5060",
            "fax_number": "407-898-5185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 E COLONIAL DR STE 107",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035200",
            "telephone_number": "407-898-5060",
            "fax_number": "407-898-5185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "RACHEL",
        "middle_name": "LYNN ANNETTE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-012829",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT40347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.