Alex DS Ellis, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

27998 Issued in CA

Practice address

129 East Line St
Bishop, CA 93514

Phone

(760) 937-0711

Fax

(760) 872-4191

NPI assigned

Mar 7, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Debrasue Alexandria Ellis Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1477055390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1554",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "93515",
            "telephone_number": "760-937-0711",
            "fax_number": "760-872-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 EAST LINE ST",
            "city": "BISHOP",
            "state": "CA",
            "postal_code": "93514",
            "telephone_number": "760-937-0711",
            "fax_number": "760-872-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ALEX",
        "middle_name": "DS",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "27998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBRASUE",
            "last_name": "ELLIS",
            "middle_name": "ALEXANDRIA",
            "credential": "MFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather Edwall, MSW
• James M. Eidel, MD
• Kirstie Eisenmann, MS
• Samer Elhakim, MD
• Paul Elia
• Emery Joseph Duncan DDS Apc
• Paulette Erwin
• Jayme Leigh Everhart, FNP-C
• F W Carter & Eric I Richman PTR Dr Carter Dr Richman Optometry
• Family Health Centre Medical Group

• Marriage & Family Therapist in Bishop, CA
• Providers in Bishop, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.