Luci Ellavich Harris, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501013495 Issued in MI

Practice address

1375 S Lapeer Rd Ste 209
Lake Orion, MI 48360-1421

Phone

(248) 814-0500

NPI assigned

Sep 27, 2007

Last updated

Mar 4, 2022By 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 1

Other names 1

• Luci Ann Ellavich Former name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Novacare Outpatient Rehabilitation East, Inc.

  dba NovaCare Rehabilitation

  • Rehabilitation Clinic/Center
  • Ferndale, MI
  • NPI 1386295210
  Medicare reassignment
• Novacare Outpatient Rehabilitation East, Inc.

  dba Novacare Rehabilitation

  • Physical Therapy Clinic/Center
  • Rochester Hills, MI
  • NPI 1316602675
  NPD
• Aks of Romeo LLC

  dba Healthquest Physical Therapy & Wellness

  • Physical Therapy Clinic/Center
  • Romeo, MI
  • NPI 1538365945

  Physical Therapist

  NPD (past)
• Healthquest Physical Therapy and Wellness Center LLC

  • Physical Therapy Clinic/Center
  • Troy, MI
  • NPI 1336344068

  Physical Therapist

  NPD (past)
• Physiotherapy Associates Inc

  dba NovaCare Rehabilitation

  • Rehabilitation Clinic/Center
  • Lake Orion, MI
  • NPI 1427155621
  NPD (past)
• Physiotherapy Associates Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD (past)

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1881881464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 S LAPEER RD STE 209",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601421",
            "telephone_number": "248-814-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 S LAPEER RD STE 209",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601421",
            "telephone_number": "248-814-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "LUCI",
        "middle_name": "ELLAVICH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-27",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501013495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "30364",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LUCI",
            "last_name": "ELLAVICH",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hakaw, P.C.
• Richard Hallowell, FNP
• Hanna Wissam-Semaan Hanna, MD
• Johnlette S Harlin
• Casandra Harper
• Deanna Hart
• Andrea Hartford, DO
• Bernice Elaine Harvey, TLLP
• Kooper James Hastings
• Elizabeth Ann Hayward, PHARMD

• Physical Therapist in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.