Active NPI
Amilia Elliott, DPT
- Physical Therapist
- Medford, OR
National Provider Identifier
1295823938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3946
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PHYSICAL THER. 2983 | NM | MD | Contractor |
| 3946 | OR | MD | Physical Therapist |
| 2983 | NM | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurotherapeutic Pediatric Therapies Inc | Physical Therapist | Past | Accepting new patients |
| Patience Grasshopper Therapeutics | Past | 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.
-
- Specialist
- Chama, NM
- NPI 1679860175
-
- Occupational Therapist
- Medford, OR
- NPI 1467995084
Physical Therapist
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.