IndividualActive
Eric Ellis, MS, LAT, ATC
NPI 1154741692 · Athletic Trainer · Havertown, PA
Provider details
- NPI number
- 1154741692
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- MS, LAT, ATC
- Sex
- Male
- Sole proprietor
- Yes
- License
- RT004288 (PA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
414 Bryan St
Havertown, PA 19083-4311
Phone: (484) 680-6341
Fax: (610) 359-1686
Street-level locationGet directions
Mailing address
414 Bryan St
Havertown, PA 19083-4311
Registry dates
- Enumerated
- 2014-04-23
- Last updated
- 2014-04-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.