Dennard W Ellison, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

48628 Issued in CO

Practice address

106 Blanca Ave
San Luis Valley Regional Medical Center
Alamosa, CO 81101-2340

Phone

(719) 589-8025

Fax

(719) 589-8087

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Allergy/ImmunologyAlso: Otolaryngology

Education

University of Florida College of Medicine, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Williamson Memorial Hospital LLC

  • General Acute Care Hospital
  • Williamson, WV
  • NPI 1275528614
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1184263527
  Care Compare affiliation
• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1376183145
  Care Compare affiliation
• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1417596834
  Care Compare affiliation
• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1427689652
  Care Compare affiliation
• Parkview Medical Center, Inc.

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1104881507
  Care Compare affiliation
• Parkview Medical Center, Inc.

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1134751712
  Care Compare affiliation
• Parkview Medical Center, Inc.

  • General Acute Care Hospital
  • Pueblo West, CO
  • NPI 1821720681
  Care Compare affiliation

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1285728659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BLANCA AVE",
            "address_2": "SAN LUIS VALLEY REGIONAL MEDICAL CENTER",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012340",
            "telephone_number": "719-589-8025",
            "fax_number": "719-589-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BLANCA AVE",
            "address_2": "SAN LUIS VALLEY REGIONAL MEDICAL CENTER",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012340",
            "telephone_number": "719-589-8025",
            "fax_number": "719-589-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "DENNARD",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-05-05",
        "certification_date": "2021-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NM",
            "license": "20020441",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "48628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "COA100184",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00182257",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52787761",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ent.dellison@direct.slvrmc.org",
            "affiliation": "N",
            "endpointDescription": "San Luis Calley Health PCP Dennard Ellison",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "106 Blanca Ave",
            "address_2": "San Luis Valley Regional Medical Center",
            "city": "Alamosa",
            "state": "CO",
            "country_code": "US",
            "postal_code": "811012340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Frances Echeverria, MSW
• Connie Edgar, N.P. C
• Jill Ann Edwards, RDH
• Gregory Mayes Elliott, MA, LPC
• Shawn A Elliott, PNP
• Lisa Erickson, MS, ATC, LAT
• Doris Erskine, RN
• Christina Espinoza
• Sally A Espinoza, MA
• Richard Esquibel, CAC III

• Otolaryngology Physician in Alamosa, CO
• Providers in Alamosa, CO by specialty
• Otolaryngology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.