Jesse Lee Ellis, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4076 Issued in OK

Practice address

1802 S Broadway St
Marlow, OK 73055-8691

Phone

(580) 721-7007

Fax

(580) 721-7008

NPI assigned

Aug 27, 2012

Last updated

Mar 24, 2016By the provider in NPPES

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

Enrolled in OK

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Ellis Chiropractic

  • Chiropractor
  • Marlow, OK
  • NPI 1407204480
  Medicare reassignment Authorized official
• Lepien Wellness Clinic, LLC

  • Chiropractor
  • Marlow, OK
  • NPI 1346536901
  NPD (past)

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1093063950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 S BROADWAY ST",
            "city": "MARLOW",
            "state": "OK",
            "postal_code": "730558691",
            "telephone_number": "580-721-7007",
            "fax_number": "580-721-7008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 S BROADWAY ST",
            "city": "MARLOW",
            "state": "OK",
            "postal_code": "730558691",
            "telephone_number": "580-721-7007",
            "fax_number": "580-721-7008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JESSE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-27",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Culver Clinic of Chiropractic, P.C.
• Cara Cummings
• Duncan Family Eye Care Inc (Marlow Family Eye Care)
• Duncan Regional Hospital, Inc (Jefferson County Hospital d/b/a Marlow Family Care)
• Ellis Chiropractic
• Jeremy Eveland
• Maria Gates, OTR/L
• Gregston Nursing Home Inc
• Jillian Jan Gregston
• Terrence Thaddeus Hampton, DMD DENTIST

• Chiropractor in Marlow, OK
• Providers in Marlow, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.