Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles Michael Ellis, PT, ATC

Individual provider Physical Therapist · NPI 1134165343

Charles Michael Ellis, PT, ATC is a Physical Therapist in Private Practice in Montgomery, Alabama. Qualified in 1989, 37 years ago. Practices with Pro Impact Physical Therapy and Sports Performance, LLC, a 4-clinician group. Licensed in Alabama.

Years since qualifying
37
Licensed in
AL
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.

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Practice location Address checks out

2000 Berry Chase Pl
Montgomery, AL 36117-6896
Phone: (334) 356-6453
Fax: (334) 239-8126
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PTH1388 (AL)

Record details

NPI number1134165343
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , ATC
Sole proprietorNo
NPI enumeratedJune 22, 2006
Last updated in NPPESJanuary 4, 2022
Certification dateJanuary 4, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1989 (37 years in practice)
Group practice Pro Impact Physical Therapy And Sports Performance, Llc — 4 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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