NPIMap

Organization Active NPI

Ellard Physical Therapy

  • Physical Therapist
  • Natchez, MS
National Provider Identifier
1699390385
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ELLARD PHYSICAL THERAPY
Practice address
290 SGT Prentiss Dr Ste a
Natchez, MS 39120-4142
Phone
(601) 600-2515
Fax
(601) 600-2515
NPI assigned
Jun 9, 2020
Last updated
Jun 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Authorized official

Name
Andrew Michael Ellard, DPTNPI 1932577921
Title
Owner, PT
Phone
(601) 600-2515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

290 SGT Prentiss Dr Ste a
Natchez, MS 39120-4142

Mailing address

290 SGT Prentiss Dr Ste a
Natchez, MS 39120-4142
Phone (601) 600-2515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200721003483 MS Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5395169510 Receives reassigned benefits from 3 practitioners
Practice locations: Natchez, MS

National Provider Directory

National Provider Directory

Locations

495 John R Junkin Dr
Natchez, MS 39120
Phone (601) 600-2515

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1699390385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 SGT PRENTISS DR STE A",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204142",
            "telephone_number": "601-600-2515",
            "fax_number": "601-600-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 SGT PRENTISS DR STE A",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204142",
            "telephone_number": "601-600-2515",
            "fax_number": "601-600-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLARD PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "ELLARD",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER, PT",
        "authorized_official_telephone_number": "601-600-2515",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchez, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.