Erica Elledge

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

1066779 Issued in OR

Practice address

101 Bodin Cir
Travis Afb, CA 94535-1809

Phone

(707) 423-7899

NPI assigned

Jan 12, 2007

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Gentle Steps Children'S Therapy Center

  • Physical Therapy Clinic/Center
  • Hillsboro, OR
  • NPI 1356410054
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563926400000",
    "number": "1629128236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEDGE",
        "first_name": "ERICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2019-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "OR",
            "license": "1066779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274802",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott A Edelstein, P.A-C
• Brody Tanner Ehalt, IDMT
• Donald Andrew Ehasz, D.C.
• Haris Ehland, D.M.D., M.S.
• Jonathan Eilers
• Andrew W Ellis, D.M.D.
• Sarah Ellis
• Alaaeldeen M. Elsayed Von Bayreuth, M.D.
• Alexander English, RN
• Timothy Eno, IDMT

• Physical Rehabilitation Occupational Therapist in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Physical Rehabilitation Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; 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.