Brian Eugene Elledge, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

9848744-1204 Issued in UT

Practice address

461 Tennessee St Ste C
Redlands, CA 92373-8161

Phone

(909) 475-7371

NPI assigned

Mar 25, 2013

Last updated

May 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Merit-based Incentive Payment System (MIPS)

Final score

68.08 of 100Reported as group

Quality

5.65

Promoting interoperability

92

Improvement activities

40

Cost

61.28

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brandon.mccullough.1@3574.direct.athenahealth.com
• Direct secure messaging: brian.elledge.1@3574.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/3574/brand/1/csg/1/fhir/r4

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.

• Jun R. Chiong, MD, MPH, Inc.

  • Internal Medicine Physician
  • Redlands, CA
  • NPI 1093099046
  Medicare reassignment NPD
• Mission City Community Network, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hollywood, CA
  • NPI 1710102009
  Medicare reassignment NPD
• Mission City Community Network, Inc.

  • Community Health Clinic/Center
  • North Hills, CA
  • NPI 1710370747
  NPD
• Corrections and Rehabilitation-Headquarters

  dba Corcoran State Prison Hospital Pharmacy

  • Pharmacy
  • Corcoran, CA
  • NPI 1376190876
  NPD (past)
• CSP-Corcoran

  • Case Management Agency
  • Corcoran, CA
  • NPI 1265772198
  NPD (past)

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

{
    "created_epoch": "1364169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1174865455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742353",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742353",
            "telephone_number": "310-482-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 TENNESSEE ST STE C",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738161",
            "telephone_number": "909-475-7371"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 E 100 N",
            "address_purpose": "LOCATION",
            "city": "Payson",
            "state": "UT",
            "postal_code": "846511600",
            "country_code": "US",
            "telephone_number": "801-465-7041",
            "fax_number": "801-465-7409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLEDGE",
        "first_name": "BRIAN",
        "middle_name": "EUGENE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-25",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A14904",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "9848744-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rabeah Elbanna, RPH
• Mary Elder, AMFT
• Graham Kendrick Eleazar
• Kimberly Dawn Elgin
• Eric Elick, M.S.
• Diane M Eller-Boyko, RN,MSW,LCSW
• Carolina Ellerbrock, RN
• Thomas Brice Elliott, PH.D.
• Kate Ellis, RN
• Michelle Ellis, LVN

• Psychiatry Physician in Redlands, CA
• Providers in Redlands, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.