NPIMap

Organization Active NPI

Robert D. Ellis, O.D. P.a.

  • Optometrist
  • Houlton, ME
National Provider Identifier
1316000276
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT525 Issued in ME
Legal business name
ROBERT D. ELLIS, O.D. P.A.
Doing business as
Aroostook Family Eyecare
Practice address
40 Court St
Houlton, ME 04730-2002
Phone
(207) 532-6503
Fax
(207) 532-3208
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert Donald Ellis, O.D.
Title
Owner
Phone
(207) 532-6503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT525 ME Primary

Addresses

Primary practice location

40 Court St
Houlton, ME 04730-2002

Mailing address

40 Court St
Houlton, ME 04730-2002
Phone (207) 532-6503

Other names 1

  • Aroostook Family Eyecare Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316000276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 COURT ST",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047302002",
            "telephone_number": "207-532-6503",
            "fax_number": "207-532-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 COURT ST",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047302002",
            "telephone_number": "207-532-6503",
            "fax_number": "207-532-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT D. ELLIS, O.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-532-6503",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ME",
            "license": "OPT525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aroostook Family Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houlton, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.