Active NPI
Dennis M. Ellingson, P.T.
- Physical Therapist
- Sacramento, CA
National Provider Identifier
1508803024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT6619
- Practice address
- 1802 7TH Ave
Sacramento, CA 95818-3808 - Phone
- (916) 709-4911
- Fax
- (916) 441-4911
- NPI assigned
- Jun 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT6619 | CA | Primary |
| Physical Therapist | 225100000X | 391 | MT |
Addresses
Primary practice location
1802 7TH Ave
Sacramento, CA 95818-3808
Mailing address
1802 7TH Ave
Sacramento, CA 95818-3808
Phone (916) 709-4911
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT6619 | CA | MD | Physical Therapist |
| 391 | MT | MD | Audiologist-Hearing Aid Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508803024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 7TH AVE",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958183808",
"telephone_number": "916-709-4911",
"fax_number": "916-441-4911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 7TH AVE",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958183808",
"telephone_number": "916-709-4911",
"fax_number": "916-441-4911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLINGSON",
"first_name": "DENNIS",
"middle_name": "M.",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT6619",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MT",
"license": "391",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.