Nicholas Ellyn, M.D., P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101027634 Issued in VA

Legal business name

NICHOLAS ELLYN, M.D., P.C.

Practice address

1707 Osage St
Suite 205
Alexandria, VA 22302-2607

Phone

(703) 578-0100

Fax

(703) 824-8357

NPI assigned

Jun 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas Ellyn, M.D.

Title

Physician

Phone

(703) 578-0100

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225065600000",
    "number": "1306006614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 OSAGE ST",
            "address_2": "SUITE 205",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223022607",
            "telephone_number": "703-578-0100",
            "fax_number": "703-824-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 OSAGE ST",
            "address_2": "SUITE 205",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223022607",
            "telephone_number": "703-578-0100",
            "fax_number": "703-824-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS ELLYN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-10",
        "last_updated": "2008-10-27",
        "status": "A",
        "authorized_official_last_name": "ELLYN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "703-578-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101027634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6380883",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1174626311",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thuan Van Nguyen, DDS
• Tiffany Ngoc Xuan Nguyen, PHARMD
• Trach N Nguyen, M.D.
• Tram-Anh Nguyen, PHARMD.
• Tuong-Van Nguyen
• Nicholas Ellyn, M.D., P.C.
• Caitlyn Elizabeth Nicholas, LCSW
• Elizabeth Lee Dye Nichols, LPC
• Dorothy Mary Nicholson, M.D.
• Rachel M Nicholson

• Specialist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2008; 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.