Active NPI
Charles T. Ellis, M.D.
- Psychiatry Physician
- Helena, MT
National Provider Identifier
1124196845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 11196
- Practice address
- 2600 Winny Ave.
Helena, MT 59601 - Phone
- (406) 422-0414
- Fax
- (612) 465-1397
- NPI assigned
- Dec 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 11196 | MT | Primary |
| Psychiatry Physician | 2084P0800X | MD60191799 | WA |
Addresses
Primary practice location
2600 Winny Ave.
Helena, MT 59601
Mailing address
2047 N. Last Chance Gulch #167
Helena, MT 59601
Phone (406) 422-0414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000914460 | Other | MT | BLUE CROSS-SHIELD OF MONTANA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11196 | MT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Mental Health | Psychiatry | Past | Accepting new patients |
| Horizon Mental Health Management LLC | Psychiatry | Past | Accepting new patients |
| Sitka Counseling & Prevention Services, Inc. | Past | Accepting new patients | |
| Uhs BH Telepsych FL, PLLC | Psychiatry | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Great Falls, MT
- NPI 1144251885
Psychiatry
-
- Counselor
- Sitka, AK
- NPI 1285764001
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427846400000",
"number": "1124196845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2047 N. LAST CHANCE GULCH #167",
"city": "HELENA",
"state": "MT",
"postal_code": "59601",
"telephone_number": "406-422-0414",
"fax_number": "612-465-1397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 WINNY AVE.",
"city": "HELENA",
"state": "MT",
"postal_code": "59601",
"telephone_number": "406-422-0414",
"fax_number": "612-465-1397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "CHARLES",
"middle_name": "T.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-01",
"last_updated": "2015-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MT",
"license": "11196",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "MD60191799",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-SHIELD OF MONTANA",
"identifier": "0000914460",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Helena, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.