Nicole Sandra Ellison, OTR/L

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

OT02018 Issued in RI

Practice address

30 Man Mar Dr
Plainville, MA 02762-2271

Phone

(508) 695-6848

NPI assigned

Aug 9, 2021

Last updated

Aug 9, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1508531906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 GILBERTS WAY",
            "city": "NORTON",
            "state": "MA",
            "postal_code": "027663465",
            "telephone_number": "774-266-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 MAN MAR DR",
            "city": "PLAINVILLE",
            "state": "MA",
            "postal_code": "027622271",
            "telephone_number": "508-695-6848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "97 Bethany Rd",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017027237",
            "country_code": "US",
            "telephone_number": "774-266-1559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "NICOLE",
        "middle_name": "SANDRA",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "RI",
            "license": "OT02018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Louise Destefano, OD
• Pam J. Difiore, N.P.
• Heidi E. Donnellan, LICSW
• Kathleen Donovan, M.A.
• Effective ABA Services LLC
• Embrace Endocrine PLLC
• Enos Home Oxygen Therapy Inc
• ENT Specialists, Inc (FYZICAL Dizziness & Fall Prevention Centers)
• Orbelina Margarita Erazo
• Steven Fairley Jr.

• Physical Rehabilitation Occupational Therapist in Plainville, MA
• Providers in Plainville, MA by specialty
• Physical Rehabilitation Occupational Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.