Thomas Ellis, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14155 Issued in TN

Practice address

2035 Saint John Ave Ste 2
Dyersburg, TN 38024-2247

Phone

(731) 325-5515

Fax

(731) 325-5517

NPI assigned

May 23, 2022

Last updated

Jun 2, 2022By the provider in NPPES

Sex

Male

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

Enrolled in MO, TN2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Star Physical Therapy LPGroup PAC ID 5496662421, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Star Physical Therapy LP

  • Physical Therapist
  • Caruthersville, MO
  • NPI 1073375861
  Medicare reassignment Care Compare group NPD
• Star Physical Therapy LP

  • Physical Therapist
  • Nashville, TN
  • NPI 1396704094
  Medicare reassignment
• PT Company

  • Physical Therapist
  • Dyersburg, TN
  • NPI 1619992450
  NPD (past)

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

{
    "created_epoch": "1653264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1609514330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681478",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370681478",
            "telephone_number": "615-591-6590",
            "fax_number": "615-591-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 SAINT JOHN AVE STE 2",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242247",
            "telephone_number": "731-325-5515",
            "fax_number": "731-325-5517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "THOMAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-23",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Healthcare Group P.C. (Pain Relief and Wellness)
• Elite Healthcare Group PC (Pain Relief and Wellness Associates)
• Elite Wound Care LLC
• Jamie L Ellerbrook, APN
• Amy Diane Ellis, COTA/L
• Eye Care Group, PLLC
• Faith Family Walk in Clinic LLC
• Family Cancer Center, PLLC
• Family Care, P.C.
• Family Practice Clinic, PC

• Physical Therapist in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.