Lora Nicole Ellis, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT4540 Issued in MS

Practice address

7381 S Siwell Rd
Ste a
Byram, MS 39272-8741

Phone

(601) 373-2075

Fax

(601) 373-2077

NPI assigned

Feb 26, 2010

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

Other names 1

• Lora Nicole Bass Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Medicomp, Inc

  • Physical Therapist
  • Magee, MS
  • NPI 1548305360
  NPD
• Medicomp, Inc

  • Physical Therapist
  • Byram, MS
  • NPI 1346332574
  NPD (past)
• Ridgeland Sports Medicine & Rehab, Inc

  • Physical Therapy Clinic/Center
  • Ridgeland, MS
  • NPI 1871689851
  NPD (past)

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

{
    "created_epoch": "1267142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1376865626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7381 S SIWELL RD",
            "address_2": "STE A",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392728741",
            "telephone_number": "601-373-2075",
            "fax_number": "601-373-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7381 S SIWELL RD",
            "address_2": "STE A",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392728741",
            "telephone_number": "601-373-2075",
            "fax_number": "601-373-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LORA",
        "middle_name": "NICOLE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-26",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "PT4540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORA",
            "last_name": "BASS",
            "middle_name": "NICOLE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dulaney Dental, PLLC
• Andrew Dulaney
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• Bethany Janette Edwards, FNP
• Elite Care Mental Health Services LLC
• Endless Possibilities Counseling and Consulting LLC
• Enduracare Acute Care Services LLC
• Felicia Evans
• Exceptional Touch Home Health, LLC
• Exceptional Touch Home Health, LLC

• Physical Therapist in Byram, MS
• Providers in Byram, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.