Individual provider Active NPI

Ashlee Ellard

  • Physical Therapist
  • Niceville, FL
National Provider Identifier
1245639012
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT28935 Issued in FL
Practice address
554 Twin Cities Blvd
Niceville, FL 32578-1066
Phone
(850) 729-3325
NPI assigned
Aug 18, 2014
Last updated
Nov 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT28935 FL Primary

Addresses

Primary practice location

554 Twin Cities Blvd
Niceville, FL 32578-1066

Mailing address

1527 Plantation Cir
Blackshear, GA 31516-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190110002866 AL Practitioner - Physical Therapist in Private Practice 0244576361 Reassigns benefits to 1 organization
I20200721003864 MS Practitioner - Physical Therapist in Private Practice 0244576361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ellard Physical TherapyGroup PAC ID 5395169510, 3 clinicians

Practice addresses (Care Compare)

495 John R Junkin Dr
Natchez, MS 39120-3825
Phone (601) 600-2515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT28935FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings of Alabama, LLC Physical Therapist CurrentSince Nov 29, 2018 Accepting new patients
Ellard Physical Therapy Physical Therapist CurrentSince Jun 7, 2020 Accepting new patients
Kelley Therapy Center Physical Therapist Past Accepting new patients

Locations

1877 Cherokee Ave SW
Cullman, AL 35055
Phone (256) 727-1701

3735 Corporate Woods Dr
Ste 109
Vestavia, AL 35242
Phone (205) 201-7358

790 Remington Blvd
Bolingbrook, IL 60440

290 Sgt Prentiss Dr
Ste A
Natchez, MS 39120
Phone (601) 520-1826

495 John R Junkin Dr
Natchez, MS 39120
Phone (601) 600-2515

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": "1408320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1245639012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 PLANTATION CIR",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "315166500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 TWIN CITIES BLVD",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781066",
            "telephone_number": "850-729-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLARD",
        "first_name": "ASHLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-18",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.