Larry Elliott Jr., PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1580 Issued in SC

Practice address

831 McDow Dr
Rock Hill, SC 29732-2415

Phone

(803) 366-5722

NPI assigned

Apr 14, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1619401809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 SWEET PEACH LN",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297156943",
            "telephone_number": "803-547-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 MCDOW DR",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322415",
            "telephone_number": "803-366-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "LARRY",
        "name_suffix": "Jr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-14",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "1580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elkins Counseling Services LLC
• Ashley P Elkins
• Shana Elkins
• Kijuana Ellam
• Courtney Lynn Ellington, LPN
• Madison Elliott
• Alexis Taylor Ellis, RBT
• Charles Wayne Ellis, CACI, MAC
• Lisa Ellis, OTR/L
• Shanelle Elmore

• Physical Therapy Assistant in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; 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.