Megan Grace Ellis, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT-1735 Issued in ID

Practice address

16171 N Brinson St
Nampa, ID 83687-5509

Phone

(208) 442-2525

Fax

(208) 442-2505

NPI assigned

Apr 14, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Idaho Therapy Source

  • Occupational Therapist
  • Nampa, ID
  • NPI 1235461732
  NPD (past)

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1871027987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16171 N BRINSON ST",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875509",
            "telephone_number": "208-442-2525",
            "fax_number": "208-442-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16171 N BRINSON ST",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836875509",
            "telephone_number": "208-442-2525",
            "fax_number": "208-442-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MEGAN",
        "middle_name": "GRACE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-1735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "OT-1735",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Eggli
• Carli Ehlers
• Jeremy Todd Ehmke, ED.S., NCSP
• Lisa Annetta Eichler, FNP
• Elevate Academy Nampa
• Kayla Marie Elston
• Nicole Ann Elton, MA
• Emerge Wellness
• Andrea Michele Emmons, LCSW
• Emp Idaho Nampa, LLC

• Occupational Therapist in Nampa, ID
• Providers in Nampa, ID by specialty
• Occupational Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.