Active NPI
Nicholas David Ellis, PHARMD, RPH
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Houston, TX
National Provider Identifier
1477322618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 74967
- Practice address
- 12620 Woodforest Blvd Ste 200
Houston, TX 77015-3568 - Phone
- (713) 451-8184
- Fax
- (713) 451-8156
- NPI assigned
- Dec 29, 2023
- Last updated
- Oct 12, 2026
- 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 |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 74967 | TX | Primary |
Addresses
Primary practice location
12620 Woodforest Blvd Ste 200
Houston, TX 77015-3568
Mailing address
12620 Woodforest Blvd Ste 200
Houston, TX 77015-3568
Phone (713) 451-8184
Other practice location 1
14221 E Sam Houston Pkwy N
Houston, TX 77044-6291
Phone (281) 670-2058
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40954 | TX | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kroger Texas LP | Past | Accepting new patients | |
| Kroger Texas LP | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791763200000",
"number": "1477322618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12620 WOODFOREST BLVD STE 200",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770153568",
"telephone_number": "713-451-8184",
"fax_number": "713-451-8156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12620 WOODFOREST BLVD STE 200",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770153568",
"telephone_number": "713-451-8184",
"fax_number": "713-451-8156"
}
],
"practiceLocations": [
{
"address_1": "14221 E Sam Houston Pkwy N",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770446291",
"country_code": "US",
"telephone_number": "281-670-2058",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELLIS",
"first_name": "NICHOLAS",
"middle_name": "DAVID",
"credential": "PHARMD, RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-12-29",
"last_updated": "2026-10-12",
"certification_date": "2026-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "TX",
"license": "74967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.