Kristin Jennifer Ellis, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2905

Practice address

850 E Butler Rd
Greenville, SC 29607-5842

Phone

(864) 527-9453

NPI assigned

Apr 22, 2013

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1366588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1831533876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 CLARENDON DR",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296429334",
            "telephone_number": "864-607-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 E BUTLER RD",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075842",
            "telephone_number": "864-527-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KRISTIN",
        "middle_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-22",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": "2905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wanda Bacher Elliott, DPT
• Jaime Elyse Elliotte, APRN
• Brittany Pirko Ellis, RN, MSN, FNP-C
• Grace Marie Ellis, OT
• James Madison Ellis, MD
• Logan William Ellis
• Madison Miranda Ellis
• William Ellis, MD
• Shawn Gray Ellison, PHYSICAL THERAPIST
• Katherine Laura Ellsworth

• Occupational Therapist in Greenville, SC
• Providers in Greenville, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; 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.