NPIMap

Individual provider Active NPI

Jeffrey Christian Ellis, PA-C

  • Physician Assistant
  • Springfield, MO
National Provider Identifier
1033454699
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2022006238 Issued in MO
Practice address
2150 W Republic Rd Ste 112
Springfield, MO 65807-6056
Phone
(417) 986-1291
NPI assigned
Dec 7, 2012
Last updated
Feb 23, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2022006238 MO Primary

Addresses

Primary practice location

2150 W Republic Rd Ste 112
Springfield, MO 65807-6056

Mailing address

2150 W Republic Rd Ste 112
Springfield, MO 65807-6056
Phone (417) 986-1291

Other practice location 1

900 E Battlefield St Ste 124
Springfield, MO 65807-5208
Phone (417) 986-1289

Other practice location 2

3233 E Sunshine St Ste 100
Springfield, MO 65804-2106
Phone (417) 812-8149

Other practice location 3

303 W Sunshine St
Springfield, MO 65807-2656
Phone (417) 986-0452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220224001578 MO Practitioner - Physician Assistant 5193152809 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Southern Missouri Ambulatory Services LLCGroup PAC ID 5193089621, 32 clinicians

Practice addresses (Care Compare)

2150 W Republic Rd
112 Mercy GH Urgent Care SW Springfield
Springfield, MO 65807-6056
Phone (417) 986-1291

303 W Sunshine St
Mercy Gohealth Urgent Care W Sunshine
Springfield, MO 65807-2656
Phone (417) 986-0452

3233 E Sunshine St
100 Mercy Gohealth Urgent Care E Sunshine
Springfield, MO 65804-2106
Phone (417) 812-8149

900 E Battlefield St
124 Mercy GH Urgent Care E Battlefield
Springfield, MO 65807-5208
Phone (417) 986-1289

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Cassville CurrentSince Feb 15, 2026 Accepting new patients
Mercy Hospital Cassville CurrentSince Feb 15, 2026 Accepting new patients
Mercy Hospital Aurora CurrentSince Feb 15, 2026 Accepting new patients
Mercy Hospital Aurora CurrentSince Feb 15, 2026 Accepting new patients

Locations

500 Porter Ave
Aurora, MO 65605
Phone (417) 678-2122

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1033454699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 W REPUBLIC RD STE 112",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658076056",
            "telephone_number": "417-986-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 W REPUBLIC RD STE 112",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658076056",
            "telephone_number": "417-986-1291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 E Battlefield St Ste 124",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658075208",
            "country_code": "US",
            "telephone_number": "417-986-1289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3233 E Sunshine St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658042106",
            "country_code": "US",
            "telephone_number": "417-812-8149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "303 W Sunshine St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658072656",
            "country_code": "US",
            "telephone_number": "417-986-0452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JEFFREY",
        "middle_name": "CHRISTIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-07",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2022006238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.