Individual provider Active NPI

Danny D. Eller, LCSW

  • Clinical Social Worker
  • Frisco, TX
National Provider Identifier
1376826966
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
59340 Issued in TX
Practice address
4645 Avon LN Ste 255
Frisco, TX 75033-1212
Phone
(469) 305-2480
NPI assigned
Sep 21, 2011
Last updated
Jun 17, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 59340 TX Primary

Addresses

Primary practice location

4645 Avon LN Ste 255
Frisco, TX 75033-1212

Mailing address

4645 Avon LN Ste 255
Frisco, TX 75033-1212
Phone (469) 305-2480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211004003005 NC Practitioner - Clinical Social Worker 4183851819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Indiana University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

230 Mosaic Blvd
Suite 45
Pittsboro, NC 27312-4947
Phone (469) 305-2480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59340TXMDClinical Social Worker

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1376826966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 AVON LN STE 255",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750331212",
            "telephone_number": "469-305-2480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 AVON LN STE 255",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750331212",
            "telephone_number": "469-305-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLER",
        "first_name": "DANNY",
        "middle_name": "D.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-21",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "59340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frisco, TX

Sources for this page

Verify at the official NPI Registry.