Kelsey Ellis, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201008965 Issued in MI

Practice address

725 Mason St
Flint, MI 48503-2421

Phone

(810) 257-3736

NPI assigned

Nov 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesee Health SystemGroup PAC ID 6002051091, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Genesee Health System

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Flint, MI
  • NPI 1043554348
  Medicare reassignment Care Compare group NPD
• Genesee Health System

  dba Genesee Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Flint, MI
  • NPI 1962140137
  NPD

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1366849374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 MASON ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 MASON ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032421",
            "telephone_number": "810-257-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KELSEY",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201008965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daneen E Eller
• Kimberly Ellies
• Amy Elliott
• Anthony Reed Ellis, M.D.
• Brian Ellis, MA, BCBA, LBA
• Linda Susan Ellis
• Thomas W Ellis
• Nykea Ellison, NP-C
• Lacie Ellithorpe, LMSW
• Sara Elmore

• Occupational Therapist in Flint, MI
• Providers in Flint, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.