David Williams Ellis, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD026575E Issued in PA

Practice address

192 W Center St
Millersburg, PA 17061-1314

Phone

(717) 692-4834

Fax

(717) 692-3678

NPI assigned

Sep 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Family Practice Center, PC

  • Clinical Medical Laboratory
  • Selinsgrove, PA
  • NPI 1033322466
  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268611200000",
    "number": "1386748747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 116",
            "address_2": "192 W CENTER ST",
            "city": "MILLERSBURG",
            "state": "PA",
            "postal_code": "17061",
            "telephone_number": "717-692-4834",
            "fax_number": "717-692-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 W CENTER ST",
            "city": "MILLERSBURG",
            "state": "PA",
            "postal_code": "170611314",
            "telephone_number": "717-692-4834",
            "fax_number": "717-692-3678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "DAVID",
        "middle_name": "WILLIAMS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2010-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "MD026575E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "EL446512",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20009377",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009476790001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "1522001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "232364010",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "02725200",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110013871",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisa Clouse, LPC
• Christina Marie Creamer, MSPT
• Dorene A Dececco, MPT
• Dr. Steven C. Weller, Inc.
• Dr. Steven C. Weller, Inc.
• Julie Marie Ellis, OTR/L
• Adrienne Kathleen Eshleman
• Krista Etzweiler, COTA/L
• Joslyn Catherine Fisch, M.S. CCC-SLP
• Tiffany Lyn Fonagy, A.T.C., P.E.S.

• General Practice Physician in Millersburg, PA
• Providers in Millersburg, PA by specialty
• General Practice Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; 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.