Richard Alan Ellis M.D,

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD016474 Issued in TN

Legal business name

RICHARD ALAN ELLIS M.D,

Practice address

3066 Fountainside Dr Ste 102
Germantown, TN 38138-7820

Phone

(901) 755-7335

Fax

(901) 755-7380

NPI assigned

Dec 16, 2010

Organization subpart

No

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

Authorized official

Name

Donica Woods Ellis, RN

Title

Practice Administrator

Phone

(901) 755-7069

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Alan Ellis, M.D.

  • Surgery Physician
  • Germantown, TN
  • NPI 1174581623

  Surgery

  NPD (past)

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358294400000",
    "number": "1033412846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3066 FOUNTAINSIDE DR STE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381387820",
            "telephone_number": "901-755-7335",
            "fax_number": "901-755-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3066 FOUNTAINSIDE DR STE 102",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381387820",
            "telephone_number": "901-755-7335",
            "fax_number": "901-755-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD ALAN ELLIS M.D,",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-16",
        "last_updated": "2013-01-16",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "DONICA",
        "authorized_official_middle_name": "WOODS",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "901-755-7069",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TN",
            "license": "MD016474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE MEDICAID",
            "identifier": "3026121",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rheumatology East PLLC
• Rheumatology Specialty Clinic PLLC
• Jessica Rhoades
• Norman Dewaine Rice, ED.D.
• Susan E Rice, NURSE PRACTITIONER
• Brenda J Richardson, MD
• David R Richardson, M.D.
• Elbert Greer Richardson, M.D.
• Shandreka Richardson
• Kelly Oconnor Richert

• Surgery Physician in Germantown, TN
• Providers in Germantown, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.