John William Ellis, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I-4923 Issued in OH

Practice address

274 Sutton Rd
Cincinnati, OH 45230-3521

Phone

(513) 231-5010

NPI assigned

Mar 26, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Integrated Behavioral Services Inc

  • Psychiatry Physician
  • Cincinnati, OH
  • NPI 1174688576
  NPD (past)

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364256000000",
    "number": "1083956155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 EDALBERT DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452397604",
            "telephone_number": "513-741-3100",
            "fax_number": "513-741-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 SUTTON RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452303521",
            "telephone_number": "513-231-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-4923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Anne Ellis
• Ericka Ellis, RN
• Glinda Cherise Ellis
• Jamie Ellis
• Jeffrey Ellis
• Jonathan David Ellis, MD
• Judith Lynn Ellis
• Markeisha Ellis
• Megan Ellis
• Nichole Ellis

• Clinical Social Worker in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.