Healthcare Provider Details

I. General information

NPI: 1881515211
Provider Name (Legal Business Name): ANN MARIE ELLIS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANN MARIE SWANSON PT, DPT

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2455 SW STATE ST
ANKENY IA
50023-1277
US

IV. Provider business mailing address

2455 SW STATE ST
ANKENY IA
50023-1277
US

V. Phone/Fax

Practice location:
  • Phone: 763-200-1529
  • Fax: 763-200-1529
Mailing address:
  • Phone: 515-963-4528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number137746
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: