Spencer Douglas Elliott, MA, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1144 Issued in NC

Practice address

Novant Health Perry & Cook Orthopedics & Sports Medicin
2826 Randolph Road
Charlotte, NC 28211-1386

Phone

(704) 358-0308

Fax

(704) 358-0039

NPI assigned

Dec 1, 2006

Last updated

Sep 8, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1841368644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6176 NEPTUNE ROAD",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280378182",
            "telephone_number": "704-564-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NOVANT HEALTH PERRY & COOK ORTHOPEDICS & SPORTS MEDICIN",
            "address_2": "2826 RANDOLPH ROAD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111386",
            "telephone_number": "704-358-0308",
            "fax_number": "704-358-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "SPENCER",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "MA, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1195",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "1144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Nicole Elliott, PA
• Matthew Ryan Elliott, MD
• Michael David Elliott, MD
• Rebecca Lynn Elliott, MD
• Robin Elliott, MD
• Adam Ellis
• Amy Cameron Ellis, RD, LDN
• Angelic Grier Ellis, PT
• Audia L. Ellis, FNP
• Cassie Ellis

• Athletic Trainer in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; 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.