Brenda Renee Ellis, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35-05-8696 Issued in OH

Practice address

7271 N Main St
Suite 3
Dayton, OH 45415-2567

Phone

(937) 277-9130

Fax

(937) 277-9165

NPI assigned

Jul 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

Meharry Medical College School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia and Pain Management LLCGroup PAC ID 2769654193, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Anesthesia and Pain Management LLC

  • Pain Medicine (Anesthesiology) Physician
  • Beavercreek, OH
  • NPI 1053600114
  Medicare reassignment Care Compare group NPD
• Anesthesia and Pain Management LLC

  • Multi-Specialty Clinic/Center
  • Beavercreek, OH
  • NPI 1952780132
  NPD (past)
• Spero Health of Ohio, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Zanesville, OH
  • NPI 1346748563
  NPD (past)

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

• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1093737330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7271 N MAIN ST",
            "address_2": "SUITE 3",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454152567",
            "telephone_number": "937-277-9130",
            "fax_number": "937-277-9165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7271 N MAIN ST",
            "address_2": "SUITE 3",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454152567",
            "telephone_number": "937-277-9130",
            "fax_number": "937-277-9165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "BRENDA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-05-8696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0753215",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casey L Elliott
• Chelsea Elliott, MSW
• Jonathan Elliott, MD
• Liam Victor Elliott
• Lindsey Nicole Elliott, APRN
• Brynn Ellis, DO
• Corey James Ellis, MD
• Daniel Byron Ellis, LPC
• Emily Catherine Ellis, PNP-PC
• Emily M Ellis, LSW

• Family Medicine Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.