Heather B Elliott, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

845 SW 30TH St Ste 100
Corvallis, OR 97331-8629

Phone

(541) 768-7700

NPI assigned

May 25, 2012

Last updated

Oct 22, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1902166853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 BEAR HOLLOW RD",
            "city": "JOELTON",
            "state": "TN",
            "postal_code": "370808912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 SW 30TH ST STE 100",
            "city": "CORVALLIS",
            "state": "OR",
            "postal_code": "973318629",
            "telephone_number": "541-768-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "HEATHER",
        "middle_name": "B",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OR",
            "license": "AT10193631",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Leonard Elias, BS, BT
• Elite Performance Wellness Center LLC (Elite Performance)
• Heather Aliceson Elkinton, MS, ATC
• James Sanford Ellingson
• Amelia Elisabeth Canright Elliott, PA
• Megan Elliott
• Melissa Marie Elliott, PHARMD
• Danielle Promise Ellis, AS, CADC I
• Todd Embree, MS, LPC, NCC, CADC I
• Alan Laird Embry, M.D.

• Athletic Trainer in Corvallis, OR
• Providers in Corvallis, OR by specialty
• Athletic Trainer in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.