Active NPI
Cheryl Lynn Ellisor, PT, DPT
- Physical Therapist
- Palestine, TX
National Provider Identifier
1407250889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1117216
- Practice address
- 3201 S Loop 256
Palestine, TX 75801-6901 - Phone
- (903) 723-0330
- NPI assigned
- Oct 14, 2014
- Last updated
- Mar 17, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1117216 | TX | Primary |
Addresses
Primary practice location
3201 S Loop 256
Palestine, TX 75801-6901
Mailing address
PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1U4936 | Other | TX | MEDICARE |
| 430137601 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1117216 | TX | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regional Physical Therapy Center Limited Partnership | Past | Accepting new patients | |
| Regional Physical Therapy Center Limited Partnership | Physical Therapist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Durable Medical Equipment & Medical Supplies
- Lufkin, TX
- NPI 1255546602
-
- Physical Therapy Clinic/Center
- Lufkin, TX
- NPI 1679663348
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647475200000",
"number": "1407250889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 846098",
"city": "DALLAS",
"state": "TX",
"postal_code": "752846098",
"telephone_number": "903-324-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201 S LOOP 256",
"city": "PALESTINE",
"state": "TX",
"postal_code": "758016901",
"telephone_number": "903-723-0330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISOR",
"first_name": "CHERYL",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-14",
"last_updated": "2022-03-17",
"certification_date": "2022-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1117216",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "1U4936",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "430137601",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palestine, TX
- Educare Community Living Limited Partnership
- Educare Community Living Limited Partnership
- Educare Community Living Limited Partnership
- Educare Community Living Limited Partnership
- Tiffany Elliott, MSN, APRN, PMHNP-BC
- Enchanted Hearts Adult Daycare
- Eric L. Hensen, DO PA
- Eye Group of Palestine, PA
- Robert J Falconer, M.D.
- Family Outreach & Resource, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.