Robert Ellison

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10785 Issued in TN

Practice address

113 Harbor Town SQ Ste 203
Memphis, TN 38103-8890

Phone

(901) 453-6081

NPI assigned

Jun 25, 2018

Sex

Male

Sole proprietor

No

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

State licenses

Practice roles

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.

• Higginbotham Dental Group, PLLC

  • General Practice Dentistry
  • Memphis, TN
  • NPI 1457717381
  NPD (past)

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1245725035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 QUINN RD",
            "city": "COLLIERVILLE",
            "state": "TN",
            "postal_code": "380173004",
            "telephone_number": "770-714-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 HARBOR TOWN SQ STE 203",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381038890",
            "telephone_number": "901-453-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "10785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joesph Ellis, PHARM D
• Laura J Ellis, MSSW
• Rita V Ellis, LCSW
• Robert Ellis Jr., PA-C
• David William Ellison, MD
• Vinkrya Ellison
• Frances Ellmo, PHD
• Rachel Loye Ellsworth
• Alexandria Thompson Ellzey, DDS
• John A Ellzey, MD

• General Practice Dentistry in Memphis, TN
• Providers in Memphis, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.