NPI age
11 years
Enumerated 2015-03-19
● Active
Type 1 · Individual
Tracy Jo Ellis, LMT
Ellis is 1 of 1 contractor providers in Hayden Lake and 1 of 20 in Idaho.
Primary specialty
Contractor
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2015-03-19
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 20 active contractor providers in Idaho.
NPI age
11 years
↓ 2 yr below median (13 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
0
15% of peers hold subspecialties
NPI lifetime · 2015 → 2026
2015-03Enumerated in NPPES
2015
2026
Where they practice
Practice location
157 W Hayden Ave
Hayden Lake, ID 838359650
Mailing address
1628 W Judy K Dr
Rathdrum, ID 838587502
Specialties
-
Contractor PrimaryFor the purposes of the Health Care Provider Taxonomy, a contractor is limited to individuals who do construction or mechanical work to modify a patient's environment to accommodate a health condition. Contractors perform projects...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.