Individual provider Active NPI

Amilia Elliott, DPT

  • Physical Therapist
  • Medford, OR
National Provider Identifier
1295823938
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3946 Issued in OR
Practice address
400 Crater Lake Ave
Medford, OR 97504-6808
Phone
(505) 756-8391
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X PHYSICAL THER. 2983 NM
Physical Therapist 225100000X 3946 OR Primary

Addresses

Primary practice location

400 Crater Lake Ave
Medford, OR 97504-6808

Mailing address

PO Box 1268
Ashland, OR 97520-0043
Phone (505) 756-8391

Other practice location 1

197 Sr 573
Tierra Amarilla, NM 87575
Phone (575) 756-8391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070911000171 NM Practitioner - Physical Therapist in Private Practice 0547353351 Practice locations: Tierra Amarilla, NM

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PHYSICAL THER. 2983NMMDContractor
3946ORMDPhysical Therapist
2983NMMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Neurotherapeutic Pediatric Therapies Inc Physical Therapist Past Accepting new patients
Patience Grasshopper Therapeutics PastSince Jun 19, 2011 Accepting new patients

Organizations & group practices 2

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1295823938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1268",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975200043",
            "telephone_number": "505-756-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 CRATER LAKE AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046808",
            "telephone_number": "505-756-8391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "197 SR 573",
            "address_purpose": "LOCATION",
            "city": "Tierra Amarilla",
            "state": "NM",
            "postal_code": "87575",
            "country_code": "US",
            "telephone_number": "575-756-8391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "AMILIA",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NM",
            "license": "PHYSICAL THER. 2983",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "3946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.