Nancy Lee Ellwood, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2574 Issued in CO

Practice address

7200 S Alton Way
Suite C-250
Centennial, CO 80112-2201

Phone

(720) 489-0790

NPI assigned

Oct 5, 2011

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

Other names 1

• Nancy Lee Gustafson Former name

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": "1317772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1598049827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6259 E CALEY DR",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801114337",
            "telephone_number": "303-771-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 S ALTON WAY",
            "address_2": "SUITE C-250",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801122201",
            "telephone_number": "720-489-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLWOOD",
        "first_name": "NANCY",
        "middle_name": "LEE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "2574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "GUSTAFSON",
            "middle_name": "LEE",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Centennial, CO
• Providers in Centennial, CO by specialty
• Occupational Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.