NPIMap

Organization Active NPI

Ellis' Family Eyecare, LLC

  • Optometrist
  • Little Egg Harbor TWP, NJ
National Provider Identifier
1053598904
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OA05056 Issued in NJ
Legal business name
ELLIS' FAMILY EYECARE, LLC
Practice address
691 Route 9 S
Millers Mall, Unit 4
Little Egg Harbor TWP, NJ 08087-4020
Phone
(609) 294-8144
Fax
(609) 512-5190
NPI assigned
Jan 23, 2008
Last updated
Feb 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Authorized official

Name
Dr. John S Ellis, ODNPI 1871569244
Title
Owner
Phone
(609) 294-8144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OA05056 NJ Primary

Addresses

Primary practice location

691 Route 9 S
Millers Mall, Unit 4
Little Egg Harbor TWP, NJ 08087-4020

Mailing address

691 Route 9 S
Millers Mall, Unit 4
Little Egg Harbor TWP, NJ 08087-4020
Phone (609) 294-8144

Other identifiers 1

IdentifierTypeStateIssuer
124542OtherNJPTAN

National Provider Directory

National Provider Directory

Locations

691 Route 9 S
Ste 4
Little Egg Harbor Twp, NJ 08087
Phone (609) 294-8144

691 Route 9 S
Unit 4
Little Egg Harbor Twp, NJ 08087
Phone (609) 294-8144

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1053598904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 ROUTE 9 S",
            "address_2": "MILLERS MALL, UNIT 4",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080874020",
            "telephone_number": "609-294-8144",
            "fax_number": "609-512-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 ROUTE 9 S",
            "address_2": "MILLERS MALL, UNIT 4",
            "city": "LITTLE EGG HARBOR TWP",
            "state": "NJ",
            "postal_code": "080874020",
            "telephone_number": "609-294-8144",
            "fax_number": "609-512-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS' FAMILY EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-294-8144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "OA05056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "124542",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Egg Harbor TWP, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.