George G Ellis Jr MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35060641E Issued in OH

Legal business name

GEORGE G ELLIS JR MD INC

Practice address

910 Boardman Canfield Rd
Boardman, OH 44512-4240

Phone

(330) 965-0832

Fax

(330) 965-0155

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Lorraine Ellis

Title

Office Manager

Phone

(330) 965-0832

Specialties & licenses 1

Addresses

Other identifiers 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3866/brand/1/csg/1/fhir/r4

Practitioners 1

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

• Thomas Andrew Bailey, MD

  • Internal Medicine Physician
  • Youngstown, OH
  • NPI 1801807607
  NPD (past)

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1073708251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124240",
            "telephone_number": "330-965-0832",
            "fax_number": "330-965-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124240",
            "telephone_number": "330-965-0832",
            "fax_number": "330-965-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE G ELLIS JR MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-965-0832",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35060641E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0894500",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2316989",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emmanuelle Twarogowski Genna, PT
• Stephanie Gensler, PHARM.D.
• James M Gentile, D.D.S.
• Kristy L Gentile, PT
• McKenzie Elizabeth Starr Gentry
• Telka Ghobadi, M.D.
• Olivia Ghobryal, MD
• Kaitlyn Gibson
• Wendy L Gill, C.R.N.P.
• Elizabeth D Gillies, LPCC

• Internal Medicine Physician in Boardman, OH
• Providers in Boardman, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.