Dale Alicia Ellison, MD

Primary specialty

Pediatric Pathology PhysicianTaxonomy code 207ZP0213X

License

E2477 Issued in AR

Practice address

800 Marshall St
Little Rock, AR 72202-3510

Phone

(501) 364-4201

NPI assigned

May 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Austin Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
  • NPI 1538172028

  Pediatric Pathology

  NPD (past)
• Austin Pathology Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Austin, TX
  • NPI 1669414330
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407808611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 MARSHALL ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MARSHALL ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722023510",
            "telephone_number": "501-364-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "DALE",
        "middle_name": "ALICIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "AR",
            "license": "E2477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Whetstone Ellis, LCSW
• Mark Bryan Ellis, OTR/L
• Rodney Ellis, OBHP
• William Patrick Ellis, PA-C
• Brent Ellison, LPC
• Destiny Ellison
• Ramona Ellison, LADAC
• Jalal Philippe Elmadi-Villeda, MD
• Carlisa Elmore
• Krystal Elmore

• Pediatric Pathology Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Pediatric Pathology Physician in Arkansas

• 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.

Verify at the official NPI Registry.