Melanie Ellsworth, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2014024987 Issued in MO

Practice address

10533 Goddard Street
Apt 331
Overland Park, KS 66214

Phone

(209) 872-0711

NPI assigned

Oct 23, 2015

Last updated

Oct 23, 2015By the provider in NPPES

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445558400000",
    "number": "1861864381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10533 GODDARD STREET",
            "address_2": "APT 331",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66214",
            "telephone_number": "209-872-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10533 GODDARD STREET",
            "address_2": "APT 331",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66214",
            "telephone_number": "209-872-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "MELANIE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-23",
        "last_updated": "2015-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KS",
            "license": "24-00962",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MO",
            "license": "2014024987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellis Health Group LLC
• Angela Ellis
• Kaitlynn Ellis
• Kelsey Leigh Ellis, LMFT
• Steven Frank Ellis, M.D.
• Katie Allison Elpers
• Ahmed Lotfy Elsaie, M.D.
• Angela Mary Elsey, PTA
• Craig Ellsworth Elson, M.D.
• Suzanne Grillot Elton, M.D.

• Athletic Trainer in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Athletic Trainer in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; 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.