Gwyneth Elliott

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

42804 Garfield Rd
Clinton Township, MI 48038-1656

Phone

(586) 323-2957

NPI assigned

Dec 18, 2017

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

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.

• Crawl Walk Jump Run Therapy Clinic

  • Rehabilitation Clinic/Center
  • Clinton Township, MI
  • NPI 1720488620
  NPD (past)
• Crawl Walk Jump Run Therapy Clinic LLC

  • Physical Therapist
  • Sterling Heights, MI
  • NPI 1730363573
  NPD (past)

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1841706579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42804 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381656",
            "telephone_number": "586-323-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42804 GARFIELD RD",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381656",
            "telephone_number": "586-323-2957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "GWYNETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ella Pharmacy LLC
• Darrin Lesley Elland
• Angeline Ellena
• Ellie Sem Clinic, PLLC
• Chelsea Elliott, DPT
• Alexander Charles Elma, DO
• Elwart Family Chiropractic PLLC
• Derek Elwart, DC
• Gillian Elwood, BEHAVIOR TECHNICIAN
• Empower Physical Therapy and Fitness

• Behavior Technician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.