Roger D. Ellis, D.C.

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

1333 Issued in TN

Practice address

1508 Scottsville Rd
Lafayette, TN 37083-2237

Phone

(501) 749-6205

NPI assigned

Feb 2, 2009

Sex

Male

Sole proprietor

Yes

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 2, 2009.

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1457599284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1508 SCOTTSVILLE RD",
            "city": "LAFAYETTE",
            "state": "TN",
            "postal_code": "370832237",
            "telephone_number": "501-749-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 SCOTTSVILLE RD",
            "city": "LAFAYETTE",
            "state": "TN",
            "postal_code": "370832237",
            "telephone_number": "501-749-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ROGER",
        "middle_name": "D.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-02",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "TN",
            "license": "1333",
            "primary": true
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "AR",
            "license": "1255",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathrine Ann Davis, PHYSICAL THERAPIST
• Sierra Brooke Day, DPT
• Christy Delk
• Jenna Renee Dillard, MA, BCBA
• Tammy Michelle Driver, RN
• Emcare Physician Providers, Inc.
• Family Care Center LLC
• Family Care Center LLC
• Fast Pace Medical Clinic PLLC
• Fast Pace Medical Clinic PLLC

• All providers in Lafayette, TN
• Orthopedic Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; 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.