John G Ellis MD Inc

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

G70713 Issued in CA

Legal business name

JOHN G ELLIS MD INC

Practice address

40949 Winchester Rd
Temecula, CA 92591-6031

Phone

(951) 296-6676

Fax

(951) 296-6675

NPI assigned

Dec 3, 2007

Last updated

Feb 20, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John G Ellis, M.D.NPI 1750351771

Title

President

Phone

(951) 296-6676

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John G Ellis, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Temecula, CA
  • NPI 1750351771
  Medicare reassignment NPD Authorized official
• Jacob Vandenmeerendonk, DPT

  • Orthopedic Physical Therapist
  • Murrieta, CA
  • NPI 1639586423
  Medicare reassignment NPD
• Bacilio Ruiz, PA

  • Physician Assistant
  • Colton, CA
  • NPI 1851932099
  Medicare reassignment
• Steven Thomas Kelley, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Temecula, CA
  • NPI 1194733402
  NPD (past)

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1396927208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40949 WINCHESTER RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925916031",
            "telephone_number": "951-296-6676",
            "fax_number": "951-296-6675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40949 WINCHESTER RD",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925916031",
            "telephone_number": "951-296-6676",
            "fax_number": "951-296-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN G ELLIS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-296-6676",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CA",
            "license": "G70713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rio Jimenez
• Richard C Jin, M.D.
• JJ Kemp Enterprises (Little Trees Pediatric Therapy)
• Caralie Jodlowski, LMFT
• Jessica Hope Johanson
• John P. Santoro, D.P.M.
• John T Shen MD, Corp
• Gabrielle John
• Kimberly Ann Johns, MSW ASW
• Heidi Lynn Johnson Schmidt, DC, ATC

• Sports Medicine (Orthopaedic Surgery) Physician in Temecula, CA
• Providers in Temecula, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.