MRS. KATHLEEN MARIE ELLIS (NPI# 1346685575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346685575 |
| Entity Type | Individual |
| Full Name | MRS. KATHLEEN MARIE ELLIS |
| Credential | LPTA |
| Practice Address |
512 Beach St Fenton MI 48430-3122 |
| Mailing Address |
11182 E Richfield Rd Davison MI 48423-8517 |
| Practice Telephone | 8106294117 |
| Mailing Telephone | 8102529888 |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-05-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 5502001225 | MI | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679902316 | Kathleen Ellis | Counselor | 65 Roselund Hill Rd, Uncasville, CT 06382-2115 | 2013-11-04 |
| 1982143350 | Kathleen Ellis | Counselor | 5424 Rufe Snow Dr, Ste 304, North Richland Hills, TX 76180-6684 | 2017-02-18 |
| 1528265014 | Kathleen Ellis | Occupational Therapist | 210 W Lacrosse Ave, Coeur D Alene, ID 83814-2403 | 2007-06-28 |
| 1003036070 | Kathleen Michelle Ellis | Physical Therapist | 178 Grandview Dr, Cobleskill, NY 12043-5144 | 2007-05-01 |
| 1073643169 | Kathleen Sue Ellis | Physical Therapist | 417 W 3rd Ave, Albany, GA 31701-1943 | 2007-03-07 |
| Street Address |
512 BEACH ST |
| City | FENTON |
| State | MI |
| Zip Code | 48430-3122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114974391 | Fenton Healthcare LLC | Skilled Nursing Facility | 512 Beach St, Fenton, MI 48430-3122 | 2006-05-31 |
| 1821580317 | Anne Marie Dorland | Occupational Therapist | 512 Beach St, Fenton, MI 48430-3122 | 2018-05-31 |
| 1144723149 | Anna Leigh Koontz | Occupational Therapist | 512 Beach St, Fenton, MI 48430-3122 | 2018-03-15 |
| 1609374685 | Aileen Fullen | Speech-Language Pathologist | 512 Beach St, Fenton, MI 48430-3122 | 2018-01-25 |
| 1922415124 | Julie Techlin | Occupational Therapist | 512 Beach St, Fenton, MI 48430-3122 | 2014-07-20 |
| 1215348958 | Cathy Blondin | Physical Therapy Assistant | 512 Beach St, Fenton, MI 48430-3122 | 2014-05-15 |
| 1184040008 | Cynthia Coleman | Physical Therapy Assistant | 512 Beach St, Fenton, MI 48430-3122 | 2014-03-16 |
| 1851715148 | Megan Teachworth | Physical Therapy Assistant | 512 Beach St, Fenton, MI 48430-3122 | 2014-02-07 |
| 1952741928 | Angela Louise Whitener | Physical Therapy Assistant | 512 Beach St, Fenton, MI 48430-3122 | 2013-07-04 |
| 1558608323 | Mindy Marie Hamp | Occupational Therapist | 512 Beach St, Fenton, MI 48430-3122 | 2013-01-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1225515091 | Erica Anderson | Social Worker | 127 River St., Fenton, MI 48430 | 2018-07-25 |
| 1245767888 | Optimum Balance | Clinic/Center | 1537 N. Leroy Street, Suite D, Fenton, MI 48430 | 2017-05-14 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1366994410 | Intentional Wellbeing LLC | Psychologist | 1122 N. Leroy Rd, Suite A, Fenton, MI 48430 | 2016-10-25 |
| 1265801625 | Shawn Marie Gorkiewicz | Nurse Practitioner | 435 North Leroy, Fenton, MI 48430 | 2015-09-16 |
| 1972994226 | Carrie Hamilton | Physical Medicine & Rehabilitation | 102 N Adelaide St Ste B, Fenton, MI 48430 | 2015-02-09 |
| 1104222520 | Wellbridge of Fenton, LLC | Skilled Nursing Facility | 901 Pine Creek Drive, Fenton, MI 48430 | 2014-11-12 |
| 1225442759 | Joseph Matthew Leppek | Optometrist | 1425 N. Leroy St., Fenton, MI 48430 | 2014-06-12 |
| 1437569647 | Therapy Support Center LLC | Clinic/Center | 113 North River Street, Fenton, MI 48430 | 2014-04-28 |
| Find all providers in zip 48430 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Nursing Facility/Intermediate Care Facility |
| An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073693826 | Fieser Nursing Center LLC | Nursing Facility/Intermediate Care Facility | 404 Main Street, Fenton, MO 63026 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669906475 | Arinas Senior Care LLC | Nursing Facility/Intermediate Care Facility | 6861 N Clunbury Rd, West Bloomfield, MI 48322-4316 | 2017-04-18 |
| 1063963304 | Susan Traut | Nursing Facility/Intermediate Care Facility | 1 Dunlap Cir, Oxford, MI 48371-5206 | 2016-10-21 |
| 1700258225 | Danielle Shilling | Nursing Facility/Intermediate Care Facility | 1011 E Central Rd, Quincy, MI 49082-9725 | 2015-10-23 |
| 1952798076 | Rehabilitation Masters PC | Nursing Facility/Intermediate Care Facility | 20331 Mauer St, Saint Clair Shores, MI 48080-1773 | 2015-04-16 |
| 1588055701 | Nextstep Billing and Payroll | Nursing Facility/Intermediate Care Facility | 3201 University Dr, Suite 250, Auburn Hills, MI 48326-2394 | 2015-02-10 |
| 1679993489 | Partners In Parenting | Nursing Facility/Intermediate Care Facility | 8235 Freda St, Detroit, MI 48204-3127 | 2014-04-18 |
| 1528491438 | Altum Care Homes | Nursing Facility/Intermediate Care Facility | 23408 Plum Hollow St, Southfield, MI 48033-3275 | 2013-08-14 |
| 1801233465 | Wellness Group Home Care LLC | Nursing Facility/Intermediate Care Facility | 26300 Ford Rd Ste 421, Dearborn Heights, MI 48127-2854 | 2013-05-22 |
| 1548537103 | Rest Haven Homes Inc | Nursing Facility/Intermediate Care Facility | 1424 Union Ave Ne, Grand Rapids, MI 49505-5197 | 2011-11-28 |
| 1649568726 | Aa Home Health Care, LLC | Nursing Facility/Intermediate Care Facility | 55 N Pond Dr Ste 1, Walled Lake, MI 48390-3080 | 2011-07-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.