Individual provider Active NPI

Heather Kaye Ellis, D.C.

  • Chiropractor
  • Cleburne, TX
National Provider Identifier
1194963397
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11046 Issued in TX
Practice address
908 W Henderson St
Cleburne, TX 76033-4836
Phone
(817) 487-0099
Fax
(682) 292-2982
NPI assigned
Jan 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11046 TX Primary

Addresses

Primary practice location

908 W Henderson St
Cleburne, TX 76033-4836

Mailing address

908 W Henderson St
Cleburne, TX 76033-4836
Phone (817) 487-0099

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

State licenses

LicenseStateTypeSpecialty
11046TXMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Texans for Chiropractic Wellness Chiropractor CurrentSince Feb 9, 2020 Accepting new patients
Corpus Christi Regenerative Therapy PLLC PastSince Jan 17, 2022 Accepting new patients

Locations

908 W Henderson St
Cleburne, TX 76033
Phone (817) 202-8464

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1194963397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 W HENDERSON ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334836",
            "telephone_number": "817-487-0099",
            "fax_number": "682-292-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "908 W HENDERSON ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760334836",
            "telephone_number": "817-487-0099",
            "fax_number": "682-292-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "HEATHER",
        "middle_name": "KAYE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-26",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.