Active NPI
Marci Dill Ellender
- Physical Therapist
- Raceland, LA
National Provider Identifier
1447564331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 07832
- Practice address
- 124 J Bar Seven Ranch Rd
Raceland, LA 70394-2047 - Phone
- (985) 637-0964
- NPI assigned
- Aug 3, 2010
- Last updated
- Feb 27, 2013
- 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 | 07832 | LA | Primary |
Addresses
Primary practice location
124 J Bar Seven Ranch Rd
Raceland, LA 70394-2047
Mailing address
270 Sugarwood Blvd
Houma, LA 70360-8351
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 |
|---|---|---|---|
| 07832 | LA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361923200000",
"number": "1447564331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "270 SUGARWOOD BLVD",
"city": "HOUMA",
"state": "LA",
"postal_code": "703608351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 J BAR SEVEN RANCH RD",
"city": "RACELAND",
"state": "LA",
"postal_code": "703942047",
"telephone_number": "985-637-0964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLENDER",
"first_name": "MARCI",
"middle_name": "DILL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-03",
"last_updated": "2013-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "LA",
"license": "07832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raceland, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.