Keven M Ellis, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6856 Issued in TX

Practice address

1302 S Medford Dr
Lufkin, TX 75901-6218

Phone

(936) 639-1488

NPI assigned

Jan 9, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023167244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1302 S MEDFORD DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759016218",
            "telephone_number": "936-639-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 S MEDFORD DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759016218",
            "telephone_number": "936-639-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KEVEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "6856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CO01890501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elite Medical Home Care LP
• Tara Jo Elizondo, PMHNP
• Elliott Chiropractic Clinic, Inc.
• Lisa Elliott
• Steven Ray Elliott, D.C.
• Lisa Gunter Ellis, PT
• Ivy Rose Embellado, PTA
• Emergency Physician Care of Garland, PLLC
• David Kent Emmerling, RPH
• Annysue Crystalin Emmons, DNP, FNP-C

• Chiropractor in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.