Kourtney Kober Ellis, D.P.T.
NPI 1093264269ActiveIndividual· Physical Therapist· Lake Charles, LA
Physical Therapist (D.P.T.) with Superior Spine and Sports Physical Therapy Inc, practicing in Lake Charles, Louisiana. Medicare paid $53,376 for services to 50 patients in 2024.
Overview
| NPI | 1093264269 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | D.P.T. |
| Sole proprietor | No |
| NPI issued | Sep 28, 2016 |
| Last updated in NPPES | Sep 28, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 09341 | LA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (LA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 50 |
|---|---|
| Services billed | 3,314 across 7 procedure codes |
| Paid by Medicare | $53,376 |
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Superior Spine and Sports Physical Therapy IncLake Charles, LA · 2 clinicians
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