Lacie Taylor Ellithorpe, OTD

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT23659 Issued in FL

Practice address

4902 Creekside Dr Ste a
Clearwater, FL 33760-4033

Phone

(727) 592-9100

Fax

(727) 592-9109

NPI assigned

Dec 23, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• I.T.S. for Kids, Inc.

  • Occupational Therapist
  • Clearwater, FL
  • NPI 1639229875
  NPD (past)

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

{
    "created_epoch": "1577059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1720627730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 SEVILLE BLVD APT 10106",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337641174",
            "telephone_number": "239-677-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 CREEKSIDE DR STE A",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337604033",
            "telephone_number": "727-592-9100",
            "fax_number": "727-592-9109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLITHORPE",
        "first_name": "LACIE",
        "middle_name": "TAYLOR",
        "name_prefix": "Miss",
        "credential": "OTD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-23",
        "last_updated": "2022-11-11",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT23659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Rose Ellis, RN
• Linda Jaye Ellis, ARNP
• Rebecca Ellis, MSW
• Theodore Ellis, DC
• Tranetta Lenise Ellis, CRNA
• Elocin Pfeiffhart Inc
• Glivery Mary Gayahan Elvambuena, M.D.
• Kailee Ely
• Embodied Therapeutic Services, LLC
• Embrace of Clearwater, Inc.

• Occupational Therapist in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.