Active NPI
Susan Elizabeth Ellington, MD
- Pediatrics Physician
- Amarillo, TX
National Provider Identifier
1467874537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- J5154
- Practice address
- 7659 Hillside Rd
Suite 300
Amarillo, TX 79119 - Phone
- (806) 322-3656
- Fax
- (806) 354-5689
- NPI assigned
- Jan 9, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | J5154 | TX | |
| Pediatrics Physician | 208000000X | J5154 | TX | Primary |
Addresses
Primary practice location
7659 Hillside Rd
Suite 300
Amarillo, TX 79119
Mailing address
2809 S Travis
Amarillo, TX 79109
Phone (806) 680-8997
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043581004 | Medicaid | TX | |
| 90458303 | Medicaid | NM | |
| 043581003 | Medicaid | TX | |
| 200564510 A | Medicaid | OK |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599609600000",
"number": "1467874537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2809 S TRAVIS",
"city": "AMARILLO",
"state": "TX",
"postal_code": "79109",
"telephone_number": "806-680-8997",
"fax_number": "806-354-5689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7659 HILLSIDE RD",
"address_2": "SUITE 300",
"city": "AMARILLO",
"state": "TX",
"postal_code": "79119",
"telephone_number": "806-322-3656",
"fax_number": "806-354-5689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLINGTON",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-09",
"last_updated": "2020-09-09",
"certification_date": "2020-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "J5154",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "J5154",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "043581004",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "90458303",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "043581003",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200564510 A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.