Active NPI
Cheryl Ann Ellis, M.D.
- Physical Medicine & Rehabilitation Physician
- Santa Barbara, CA
National Provider Identifier
1366460636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- G50999
- Practice address
- 2415 De la Vina St
Santa Barbara, CA 93105-3819 - Phone
- (805) 569-8999
- Fax
- (805) 569-8941
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | G50999 | CA | Primary |
Addresses
Primary practice location
2415 De la Vina St
Santa Barbara, CA 93105-3819
Mailing address
126 Hermosa Dr
Pismo Beach, CA 93449-1523
Phone (805) 569-8999
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G50999 | CA | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366460636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 HERMOSA DR",
"city": "PISMO BEACH",
"state": "CA",
"postal_code": "934491523",
"telephone_number": "805-569-8999",
"fax_number": "805-569-8941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 DE LA VINA ST",
"city": "SANTA BARBARA",
"state": "CA",
"postal_code": "931053819",
"telephone_number": "805-569-8999",
"fax_number": "805-569-8941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "CHERYL",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "CA",
"license": "G50999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Barbara, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.