Kelsey E Ellis, PT DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1563 Issued in WY

Practice address

1401 Gateway Blvd
Suite 2
Rock Springs, WY 82901-6717

Phone

(307) 352-3626

Fax

(307) 352-3628

NPI assigned

Feb 11, 2015

Last updated

Oct 19, 2015By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fremont Therapy Group LLC

  • Physical Therapist
  • Riverton, WY
  • NPI 1477568046
  Medicare reassignment NPD
• Caring Edge Op LLC

  • Clinic/Center
  • Eagle, ID
  • NPI 1700399359

  WY

  Medicare reassignment
• Legacy Primary Care PLLC

  • Adult Medicine Physician
  • Grand Forks, ND
  • NPI 1265277115
  NPD

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1720479702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 GATEWAY BLVD",
            "address_2": "SUITE 2",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829016717",
            "telephone_number": "307-352-3626",
            "fax_number": "307-352-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 GATEWAY BLVD",
            "address_2": "SUITE 2",
            "city": "ROCK SPRINGS",
            "state": "WY",
            "postal_code": "829016717",
            "telephone_number": "307-352-3626",
            "fax_number": "307-352-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KELSEY",
        "middle_name": "E",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT1563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn June Edwards, RPH
• Ryann Edwards
• Wendy Edwards
• Paul Allen Egleston, PA-C
• Lafe A Ellerbeck, PHARMD
• Empres at Rock Springs, LLC (Sage View Care Center)
• Richard Lee Endorf, M.D.
• Eric Meyer MD PC
• Greg Gaston Erramouspe, D.D.S.
• Shauna Lyn Erramouspe, MS RD LD

• Physical Therapist in Rock Springs, WY
• Providers in Rock Springs, WY by specialty
• Physical Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.