Active NPI
Rayford Ellison, PT
- Physical Therapist
- Southfield, MI
National Provider Identifier
1710551023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501011108
- Practice address
- 29877 Telegraph Rd
Southfield, MI 48034-1332 - Phone
- (248) 450-3163
- NPI assigned
- May 20, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501011108 | MI | Primary |
Addresses
Primary practice location
29877 Telegraph Rd
Southfield, MI 48034-1332
Mailing address
31755 Ridgeside Dr Apt 24
Farmingtn HLS, MI 48334-1276
Phone (313) 506-0909
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621468800000",
"number": "1710551023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31755 RIDGESIDE DR APT 24",
"city": "FARMINGTN HLS",
"state": "MI",
"postal_code": "483341276",
"telephone_number": "313-506-0909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29877 TELEGRAPH RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480341332",
"telephone_number": "248-450-3163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "RAYFORD",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-05-20",
"last_updated": "2021-05-20",
"certification_date": "2021-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501011108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.