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

Dr. Robert Ray Ellis, DPT

Individual provider Military Health Care Provider · NPI 1881945566

Dr. Robert Ray Ellis, DPT is a Physical Therapist in Private Practice in Diberville, Mississippi. Qualified in 2012, 14 years ago. Practices with Dynamic Rehabilitation Services, LLC, a 6-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
14
Licensed in
MS
In the registry since
2012
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

See every abbreviation used in this directory →

Practice location Address checks out

4016 Cassimer Ave
Diberville, MS 39540-2309
Phone: (228) 326-1115
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT5070 (MS)
Military Health Care Provider Taxonomy 171000000X · Licence PT5070 (MS)

Record details

NPI number1881945566
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorYes
NPI enumeratedSeptember 21, 2012
Last updated in NPPESDecember 15, 2023
Certification dateDecember 15, 2023
Mailing address4016 Cassimer Ave, Diberville, MS 39540-2309

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Dynamic Rehabilitation Services, Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare