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

Mr. Kelly Wynell Ellis, PTA

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1205455789

Mr. Kelly Wynell Ellis, PTA is a Physical Medicine & Rehabilitation Physician in Toledo, Ohio. Licensed in Ohio. Registered with an NPI since 2020.

Licensed in
OH
In the registry since
2020
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

5502 San Juan Dr
Toledo, OH 43612-3336
Phone: (419) 410-7741
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence PTA007644 (OH)

Record details

NPI number1205455789
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedApril 14, 2020
Last updated in NPPESApril 14, 2020
Certification dateApril 14, 2020

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