Dustin Ely

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA22832 Issued in FL

Practice address

411 E Orange St
Suite 204
Lakeland, FL 33801-5054

Phone

(863) 617-9400

NPI assigned

Jun 18, 2014

Sex

Male

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1871907808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6470 HORIZON POINT DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338135407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E ORANGE ST",
            "address_2": "SUITE 204",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015054",
            "telephone_number": "863-617-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "DUSTIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-18",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA22832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fakhir F. Elmasri, M. D.
• Alexander Elortegui, DO
• Sophia Elortegui, DO
• Elouise Caring Hands Homecare Services LLC
• Erika Rogawski Elsinger, M.S.
• Mahmoud Elyaman, CRNA
• Embrace to Empower Wellness Center
• Embraced Behavioral Health
• Amanda Louise Embry, MA, RMHCI
• Emergent Therapy Center LLC

• Physical Therapy Assistant in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Physical Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; 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.