Individual provider Active NPI

Merrick Ellis, RBT

  • Behavior Technician
  • Grove, OK
National Provider Identifier
1477467660
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1629 S Main St
Grove, OK 74344-5368
Phone
(918) 557-4496
NPI assigned
Oct 2, 2026
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X NU Primary

Addresses

Primary practice location

1629 S Main St
Grove, OK 74344-5368

Mailing address

553 S Colcord Ave
Colcord, OK 74338-1740
Phone (479) 228-2429

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1477467660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 S COLCORD AVE",
            "city": "COLCORD",
            "state": "OK",
            "postal_code": "743381740",
            "telephone_number": "479-228-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 S MAIN ST",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743445368",
            "telephone_number": "918-557-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MERRICK",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grove, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.