Active NPI
Ellen Joy Pong, DPT, MOTR/L, CCE
- Occupational Therapist
- Milton, FL
National Provider Identifier
1508825068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11232
- Practice address
- 5147 Gardenbrook Blvd
Milton, FL 32570-2331 - Phone
- (850) 983-6147
- Fax
- (850) 983-8973
- NPI assigned
- Mar 22, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 20974 | FL | |
| Occupational Therapist | 225X00000X | 11232 | FL | Primary |
Addresses
Primary practice location
5147 Gardenbrook Blvd
Milton, FL 32570-2331
Mailing address
5147 Gardenbrook Blvd
Milton, FL 32570-2331
Phone (850) 983-6147
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 |
|---|---|---|---|
| 11232 | FL | MD | Internal Medicine Physician |
| 20974 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1508825068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5147 GARDENBROOK BLVD",
"city": "MILTON",
"state": "FL",
"postal_code": "325702331",
"telephone_number": "850-983-6147",
"fax_number": "850-983-8973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5147 GARDENBROOK BLVD",
"city": "MILTON",
"state": "FL",
"postal_code": "325702331",
"telephone_number": "850-983-6147",
"fax_number": "850-983-8973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONG",
"first_name": "ELLEN",
"middle_name": "JOY",
"name_prefix": "Dr.",
"credential": "DPT, MOTR/L, CCE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-22",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "20974",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "11232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.