Cheryl Vanderbilt-Ellis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA08693 Issued in TX

Practice address

1935 Medical District Dr
Dallas, TX 75235-7701

Phone

(214) 456-0776

Fax

(214) 867-5398

NPI assigned

Sep 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: cheryl.vanderbilt-ellis.1@27041.direct.athenahealth.com

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1497940316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-0776",
            "fax_number": "214-867-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-0776",
            "fax_number": "214-867-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBILT-ELLIS",
        "first_name": "CHERYL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085002695",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA08693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie E. Vance, NNP
• Linda L Vance
• Sheri Amanda Vancura, RD, LD
• Jerre Tiede Vandenbent, PT
• Sherry Marie Vander Velden, CRNA
• Drew Vanderbrook, DDS
• Heidi McMahan Vanderbrook, NP-C
• Bree Vanderburg, RBT
• Landry Vandergriff, RBT
• Travis Wade Vandergriff, MD

• Medical Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.