Cynthia Marie Elliott, OTRL

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

718 Issued in MT

Practice address

40403 Forman Rd
Polson, MT 59860-8366

Phone

(406) 883-2223

Fax

(406) 883-2223

NPI assigned

Nov 12, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1518038652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40403 FORMAN RD",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598608366",
            "telephone_number": "406-883-2223",
            "fax_number": "406-883-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40403 FORMAN RD",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598608366",
            "telephone_number": "406-883-2223",
            "fax_number": "406-883-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MT",
            "license": "718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "661110",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "342482",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Dupea, MD
• Derrek Durocher, DC
• Jesse Rae Durocher, DC
• Shana Eaglefeathers, DO
• Rachel Edington, LCPC
• Jamie Michael Engeldrum, PA-C
• Donald Paul Ericksen, M.D.
• David Jason Erickson I, L.M.T
• Evergreen at Polson, L.L.C. (Polson Health and Rehabilitation Center)
• Fairbank Counseling, PLLC

• Pediatric Occupational Therapist in Polson, MT
• Providers in Polson, MT by specialty
• Pediatric Occupational Therapist in Montana

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

Verify at the official NPI Registry.