Active NPI
Lauren Elizabeth Ellis, COTA/L
- Occupational Therapy Assistant
- Pauls Valley, OK
National Provider Identifier
1780111211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1528
- Practice address
- 1740 S Walnut St
Pauls Valley, OK 73075-6919 - Phone
- (405) 222-8716
- NPI assigned
- May 15, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1528 | OK | Primary |
Addresses
Primary practice location
1740 S Walnut St
Pauls Valley, OK 73075-6919
Mailing address
1740 S Walnut St
Pauls Valley, OK 73075-6919
Phone (405) 222-8716
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528 | Other | OK | OKLAHOMA MEDICAL BOARD LISCENSE COTA/L |
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quest Pediatric Therapy | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Occupational Therapist
- Oklahoma City, OK
- NPI 1417335225
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1780111211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1740 S WALNUT ST",
"city": "PAULS VALLEY",
"state": "OK",
"postal_code": "730756919",
"telephone_number": "405-222-8716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 S WALNUT ST",
"city": "PAULS VALLEY",
"state": "OK",
"postal_code": "730756919",
"telephone_number": "405-222-8716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "LAUREN",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OK",
"license": "1528",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLAHOMA MEDICAL BOARD LISCENSE COTA/L",
"identifier": "1528",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pauls Valley, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.