Individual provider Active NPI

Scott D. Ellison, M.D.

  • Surgery Physician
  • Kansas City, KS
National Provider Identifier
1497780159
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0429187 Issued in KS
Practice address
8919 Parallel Pkwy Ste 270
Kansas City, KS 66112-1655
Phone
(913) 334-6800
Fax
(913) 334-0875
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0429187 KS Primary

Addresses

Primary practice location

8919 Parallel Pkwy Ste 270
Kansas City, KS 66112-1655

Mailing address

8919 Parallel Pkwy Ste 270
Kansas City, KS 66112-1655
Phone (913) 334-6800

Other practice location 1

8919 Parallel Pkwy Ste 206
Kansas City, KS 66112-1655
Phone (913) 334-6800

Other practice location 2

7255 Renner Rd
Shawnee, KS 66217-3043
Phone (913) 334-6800

Other identifiers 1

IdentifierTypeStateIssuer
100397360AMedicaidKS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080605000355 KS Practitioner - General Surgery 8628148400 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Physician Services - Providence Inc Surgery CurrentSince Apr 1, 2013 Accepting new patients
Prime Healthcare Physician Services - Providence Inc CurrentSince Apr 1, 2013 Accepting new patients
Providence Care Inc Past Accepting new patients

Locations

15604 Pinehurst Dr
Basehor, KS 66007
Phone (913) 728-2200

913 Sheidley Ave
Bonner Springs, KS 66012
Phone (816) 301-4533

8935 State Ave
Kansas City, KS 66112
Phone (816) 389-6030

8919 Parallel Pkwy
Ste 270
Kansas City, KS 66112
Phone (913) 321-0522

8929 Parallel Pkwy
Kansas City, KS 66112
Phone (913) 596-3930

8919 Parallel Pkwy
Ste 206
Kansas City, KS 66112
Phone (913) 334-9800

757 W Eisenhower Rd
#R
Lansing, KS 66043
Phone (913) 297-2299

3500 S 4th St
Leavenworth, KS 66048
Phone (913) 469-1411

3550 S 4th St
Ste 282
Leavenworth, KS 66048
Phone (913) 318-7821

7315 E Frontage Rd
Ste 114
Merriam, KS 66204
Phone (913) 334-6500

7255 Renner Rd
Shawnee Mission, KS 66217
Phone (913) 631-0405

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

9100 W 74th St
Shawnee Msn, KS 66204
Phone (913) 632-2230

1000 Carondelet Dr
Kansas City, MO 64114
Phone (816) 942-4400

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1497780159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8919 PARALLEL PKWY STE 270",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661121655",
            "telephone_number": "913-334-6800",
            "fax_number": "913-334-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8919 PARALLEL PKWY STE 270",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661121655",
            "telephone_number": "913-334-6800",
            "fax_number": "913-334-0875"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8919 Parallel Pkwy Ste 206",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "KS",
            "postal_code": "661121655",
            "country_code": "US",
            "telephone_number": "913-334-6800",
            "fax_number": "913-334-0875",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7255 Renner Rd",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "KS",
            "postal_code": "662173043",
            "country_code": "US",
            "telephone_number": "913-334-6800",
            "fax_number": "913-334-0875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "SCOTT",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "0429187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100397360A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

Verify at the official NPI Registry.