Richard Leroy Ellis, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

DO145 Issued in AL

Practice address

2657 Park Lane CT East--Unit F
Birmingham, AL 35223

Phone

(205) 879-1386

NPI assigned

Aug 31, 2007

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1104010206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2657 PARK LANE CT EAST--UNIT F",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35223",
            "telephone_number": "205-879-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2657 PARK LANE CT EAST--UNIT F",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35223",
            "telephone_number": "205-879-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "RICHARD",
        "middle_name": "LEROY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-31",
        "last_updated": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "DO145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brennan Phillip Ellis, CRNP
• Charles H. Ellis, DMD
• Frank Ellis, AGACNP
• Jack Ellis, P.T.
• Kelli S Ellis, M.S. CCC-SLP
• Shannon B Ellis, M.D.
• Brandon Taylor Ellison
• Brian Ellison
• Clayton Samuel Ellison, D.C.
• India Ellison

• General Practice Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• General Practice Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; 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.