Individual provider Active NPI

Christopher John Ellis, P.T.

  • Physical Therapist
  • Aventura, FL
National Provider Identifier
1649450388
Registry record updated Aug 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT24154 Issued in FL
Practice address
21000 NE 28TH Ave
Ste 104
Aventura, FL 33180-1421
Phone
(716) 870-0728
NPI assigned
Nov 9, 2007
Last updated
Aug 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2187 NV
Physical Therapist 225100000X PT24154 FL Primary

Addresses

Primary practice location

21000 NE 28TH Ave
Ste 104
Aventura, FL 33180-1421

Mailing address

21000 NE 28TH Ave
Ste 104
Aventura, FL 33180-1421
Phone (716) 870-0728

Other practice location 1

600 S Rancho Dr
#103
Las Vegas, NV 89106-4867
Phone (702) 258-9381

Other identifiers 1

IdentifierTypeStateIssuer
1649450388MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119000197 FL Practitioner - Physical Therapist in Private Practice 9830288463 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Miami, LM Miller School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Force Physical Therapy Davie LLCGroup PAC ID 6406133560, 5 clinicians
Force Physiotherapy Fort Lauderdale LLCGroup PAC ID 2860936929, 5 clinicians

Practice addresses (Care Compare)

2250 SW 71 Terr
Davie, FL 33317-7136
Phone (954) 806-5896

2250 SW 71St Ter
Davie, FL 33317-7136

500 S Andrews Ave
Suite 120
Fort Lauderdale, FL 33301-4433
Phone (954) 806-5896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT24154FLMDPhysical Therapist
2187NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Force Physical Therapy LLC Physical Therapist CurrentSince Sep 10, 2010 Accepting new patients
Force Physical Therapy North Miami, LLC Physical Therapist CurrentSince Aug 6, 2021 Accepting new patients
Force Physiotherapy Fort Lauderdale LLC Physical Therapist CurrentSince Apr 11, 2024 Accepting new patients
Force Physical Therapy Davie LLC Physical Therapist CurrentSince Oct 15, 2016 Accepting new patients
Force Physiotherapy Wynwood LLC Physical Therapist PastSince Oct 18, 2023 Accepting new patients
Force Physical Therapy Coconut Grove LLC Physical Therapist PastSince May 16, 2022 Accepting new patients

Locations

5300 Island Blvd
Aventura, FL 33160
Phone (305) 332-4913

2250 SW 71st Ter
Davie, FL 33317
Phone (954) 806-5896

500 S Andrews Ave
Ste 120
Fort Lauderdale, FL 33301
Phone (716) 870-0728

21000 NE 28th Ave
Ste 104
Miami, FL 33180
Phone (305) 933-0626

21150 Biscayne Blvd
Ste 406
Miami, FL 33180

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628208000000",
    "number": "1649450388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21000 NE 28TH AVE",
            "address_2": "STE 104",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801421",
            "telephone_number": "716-870-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 NE 28TH AVE",
            "address_2": "STE 104",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801421",
            "telephone_number": "716-870-0728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 S Rancho Dr",
            "address_2": "#103",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064867",
            "country_code": "US",
            "telephone_number": "702-258-9381",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-09",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2187",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT24154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1649450388",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.