Janenne E Ellis, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P2997 Issued in NC

Practice address

10000 Beach Dr SW Unit 9
Calabash, NC 28467-2856

Phone

(910) 579-2745

Fax

(910) 579-2847

NPI assigned

Jun 8, 2006

Last updated

Aug 12, 2020By 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 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Level Up Physical Therapy IncGroup PAC ID 4587919931, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Level Up Physical Therapy Inc

  • Physical Therapist
  • Carolina Shores, NC
  • NPI 1508367087
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1871533570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 BEACH DR SW UNIT 9",
            "city": "CALABASH",
            "state": "NC",
            "postal_code": "284672856",
            "telephone_number": "910-579-2745",
            "fax_number": "910-579-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BEACH DR SW UNIT 9",
            "city": "CALABASH",
            "state": "NC",
            "postal_code": "284672856",
            "telephone_number": "910-579-2745",
            "fax_number": "910-579-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JANENNE",
        "middle_name": "E",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P2997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "501889202",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTHEALTH/MAILHANDLERS",
            "identifier": "1180992",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "1131H",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPART OF LABOR",
            "identifier": "125357800",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST PROVIDER #",
            "identifier": "E2499",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mayson Cox
• Carrie Wemyss Danford, PHARM.D.
• Deeb & Fanning DDS PA
• David Philip Deeb, DDS
• Desired Changes, PLLC
• Frederick R Ellwanger III, MD
• Empowher Health Services
• Michael John Fanning, DDS
• Forever Yours, Inc
• Ganglani Calabash PLLC (Deeb & Fanning, DDS, PA)

• Physical Therapist in Calabash, NC
• Providers in Calabash, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.