Evan Gibson Baity Elliott

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501016414 Issued in MI

Practice address

2545 Capital Ave SW
Battle Creek, MI 49015-7120

Phone

(266) 979-3000

Fax

(239) 979-9770

NPI assigned

Mar 14, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: evan.elliott.p1@direct.gracehealthmi.nextgenshare.com

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.

• Alliance Physical Therapy Group LLC

  • Physical Therapist
  • Holland, MI
  • NPI 1649216144
  Medicare reassignment NPD
• Muscle & Spine Rehabilitation Center LLC

  • Physical Therapy Clinic/Center
  • Battle Creek, MI
  • NPI 1023117876
  NPD

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1366945545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 GULL RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 CAPITAL AVE SW",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490157120",
            "telephone_number": "266-979-3000",
            "fax_number": "239-979-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "EVAN",
        "middle_name": "GIBSON BAITY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-14",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501016414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55010106414",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric A Eldred, PHARM D.
• Rossetta Divina Eldred
• Elevated Therapeutic Services LLC
• Joshua F Elijah, PHYSICIAN ASSISTANT
• Darlene Merrill Elliott, PTA
• Jason Merrill Elliott, FNP-C
• Tarek Elshaarawy, M.D.
• Heather M Elwell, PTA
• Kathryn Marie Ely, PHARMD
• Embraced Home Care LLC

• Physical Therapist in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.