Active NPI
John Allan Elli, P.A.-C.
- Physician Assistant
- Memphis, TN
National Provider Identifier
1437169380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA0000000958
- Practice address
- 1030 Jefferson
Memphis, TN 38104 - Phone
- (901) 523-8990
- Fax
- (901) 577-7434
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA0000000958 | TN | Primary |
Addresses
Primary practice location
1030 Jefferson
Memphis, TN 38104
Mailing address
1459 Poplar Estates Pkwy
Germantown, TN 38138-1840
Phone (901) 753-4033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 958 | TN | MD | Optician |
| PA0000000958 | TN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1437169380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1459 POPLAR ESTATES PKWY",
"city": "GERMANTOWN",
"state": "TN",
"postal_code": "381381840",
"telephone_number": "901-753-4033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 JEFFERSON",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "38104",
"telephone_number": "901-523-8990",
"fax_number": "901-577-7434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLI",
"first_name": "JOHN",
"middle_name": "ALLAN",
"name_prefix": "Mr.",
"credential": "P.A.-C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "PA0000000958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.