Robert E Ellis MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

19194 Issued in KY

Legal business name

ROBERT E ELLIS MD

Practice address

9115 Leesgate Rd
Suite C
Louisville, KY 40222-5003

Phone

(502) 719-0782

Fax

(502) 719-0787

NPI assigned

Feb 20, 2007

Last updated

Aug 13, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert E Ellis, M.D.NPI 1427006816

Title

President

Phone

(502) 719-0782

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Ellsworth Ellis, M.D.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1427006816
  Medicare reassignment NPD Authorized official
• Garrett M Crabtree, M.D.

  • Dermatology Physician
  • Louisville, KY
  • NPI 1407972060
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250121600000",
    "number": "1154465276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9115 LEESGATE RD",
            "address_2": "SUITE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225003",
            "telephone_number": "502-719-0782",
            "fax_number": "502-719-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9115 LEESGATE RD",
            "address_2": "SUITE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225003",
            "telephone_number": "502-719-0782",
            "fax_number": "502-719-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT E ELLIS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2009-08-13",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-719-0782",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "19194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenice Roberson, CPT
• Lynn Allan Roberson, LMT
• Megan Marie Roberson, LCSW
• Molly Roberson, PA
• Robert B. Nolan, Jr., MD, PLLC
• Robert E Emig D C PLLC (Emig Chiropractic Center)
• Robert E. Emig DC PLLC
• Robert G Hammer MD & Associates (Robert G Hammer MD)
• Robert H. Stewart, MD PSC
• Robert J. Homm, MD, PSC (Fertility & Endocrine Associates)

• Internal Medicine Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; 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.