Individual provider Active NPI

Autumn Ellis, DPT

  • Physical Therapist
  • Nokomis, FL
National Provider Identifier
1659930147
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PENDING Issued in FL
Practice address
115 Tamiami TRL N Ste 8
Nokomis, FL 34275-2162
Phone
(941) 218-0158
NPI assigned
Jun 10, 2019
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PENDING FL Primary

Addresses

Primary practice location

115 Tamiami TRL N Ste 8
Nokomis, FL 34275-2162

Mailing address

115 Tamiami TRL N Ste 8
Nokomis, FL 34275-2162
Phone (941) 218-0158

Other identifiers 1

IdentifierTypeStateIssuer
PT34734OtherFLPHYSICAL THERAPIST LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190909004041 FL Practitioner - Physical Therapist in Private Practice 3274862792 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empath Therapies LLCGroup PAC ID 5496144529, 108 clinicians

Practice addresses (Care Compare)

Venice, FL 34292
Phone (941) 822-7143

3600 William Penn Way
Venice, FL 34293-5236
Phone (941) 483-0746

Merit-based Incentive Payment System (MIPS)

Final score
63.05 of 100Reported as group
Quality
27.45
Improvement activities
40
Cost
73.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGFLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agility Physical Therapy & Sports Performance, LLC Physical Therapist CurrentSince Aug 1, 2019 Accepting new patients
Flex Physical Therapy & Wellness LLC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Empath Therapies, LLC Physical Therapist CurrentSince Oct 14, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Aug 8, 2020 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Aug 8, 2020 Accepting new patients

Locations

115 Tamiami Trl N
Ste 8
Nokomis, FL 34275
Phone (941) 218-0158

5955 Rand Blvd
Sarasota, FL 34238
Phone (941) 552-7500

1420 E Venice Ave
Venice, FL 34292
Phone (866) 226-9567

1525 Tamiami Trl S
Ste 604
Venice, FL 34285
Phone (941) 484-8107

834 Pinebrook Rd
Venice, FL 34285
Phone (941) 484-8107

Networks

  • Freedom Health HMO Network

Organizations & group practices 5

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": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1659930147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 TAMIAMI TRL N STE 8",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342752162",
            "telephone_number": "941-218-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 TAMIAMI TRL N STE 8",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342752162",
            "telephone_number": "941-218-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "AUTUMN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST LICENSE",
            "identifier": "PT34734",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nokomis, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; 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.