Active NPI
Keith Anthony Ellison, R.T.(R)(CT)(ARRT)
- Computed Tomography Radiologic Technologist
- Portsmouth, VA
National Provider Identifier
1427779073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Computed Tomography Radiologic Technologist
- License
- 256008
- Practice address
- 711 Court St
Portsmouth, VA 23704-3625 - Phone
- (757) 648-9284
- NPI assigned
- Sep 12, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Computed Tomography Radiologic Technologist | 2471C3401X | 256008 | Primary |
Addresses
Primary practice location
711 Court St
Portsmouth, VA 23704-3625
Mailing address
711 Court St
Portsmouth, VA 23704-3625
Phone (757) 648-9284
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1427779073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 COURT ST",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237043625",
"telephone_number": "757-648-9284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 COURT ST",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237043625",
"telephone_number": "757-648-9284"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "KEITH",
"middle_name": "ANTHONY",
"credential": "R.T.(R)(CT)(ARRT)",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-09-12",
"last_updated": "2022-09-12",
"certification_date": "2022-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "2471C3401X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Computed Tomography",
"state": null,
"license": "256008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.