Lance A. Ellis, DO

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

M4053 Issued in TX

Practice address

1507 W Main St
Gatesville, TX 76528-1024

Phone

(254) 865-2166

Fax

(254) 248-0626

NPI assigned

Mar 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Orthopedic Surgery

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coryell County Memorial Hospital AuthorityGroup PAC ID 7719886282, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Paradigm Home Health Home health agency, Whitney, TX, CCN 747950
• Coryell Memorial Hospital Hospital, Gatesville, TX, CCN 451379
• Ascension Providence Hospital, Waco, TX, CCN 450042

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fmclellis@yourcarecommunity.org
• Direct secure messaging: lance.ellis.1@9635.direct.athenahealth.com

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.

• Coryell County Memorial Hospital Authority

  • Anesthesiology Physician
  • Gatesville, TX
  • NPI 1992832521
  Medicare reassignment Care Compare group NPD
• Total Trauma Care, PLLC

  • Orthopaedic Trauma Physician
  • Shenandoah, TX
  • NPI 1790235083

  Orthopaedic Surgery of the Spine

  NPD
• Scott & White Hospital - Taylor

  • Emergency Medicine Physician
  • Taylor, TX
  • NPI 1659366557
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension Providence

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1093708679
  Care Compare affiliation
• Coryell County Memorial Hospital Authority

  • Critical Access Hospital
  • Gatesville, TX
  • NPI 1780823021
  Care Compare affiliation
• Lake Whitney Operations, LLC

  • Home Health Agency
  • Whitney, TX
  • NPI 1891114963
  Care Compare affiliation

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1508826074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 W MAIN ST",
            "city": "GATESVILLE",
            "state": "TX",
            "postal_code": "765281024",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 W MAIN ST",
            "city": "GATESVILLE",
            "state": "TX",
            "postal_code": "765281024",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 HILLCREST DR",
            "address_2": "STE 1",
            "address_purpose": "LOCATION",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767083144",
            "country_code": "US",
            "telephone_number": "888-624-6882",
            "fax_number": "888-395-9138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5100 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767106922",
            "country_code": "US",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "404 Avenue E",
            "address_purpose": "LOCATION",
            "city": "Moody",
            "state": "TX",
            "postal_code": "765573579",
            "country_code": "US",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1510 Hannh Valley Road",
            "address_purpose": "LOCATION",
            "city": "Goldthwaite",
            "state": "TX",
            "postal_code": "76844",
            "country_code": "US",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "125 Newman St",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "TX",
            "postal_code": "758401419",
            "country_code": "US",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10201 Highway 16",
            "address_purpose": "LOCATION",
            "city": "Comanche",
            "state": "TX",
            "postal_code": "764424462",
            "country_code": "US",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1007 W Business 190 Ste B",
            "address_purpose": "LOCATION",
            "city": "Copperas Cove",
            "state": "TX",
            "postal_code": "765223886",
            "country_code": "US",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6208 W Adams Ave",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765025526",
            "country_code": "US",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LANCE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MI",
            "license": "5101015902",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OH",
            "license": "34-007955",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "M4053",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "TX",
            "license": "M4053",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "MI",
            "license": "5101015902",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "OH",
            "license": "34-007955",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "TX",
            "license": "M4053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "M4053",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lellis@ch.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Coryell Health Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1507 W Main St",
            "city": "Gatesville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765281024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelli Dudley
• Kevin W. Dwyer, M.D.
• Alecia Nicole Eads, FNP
• Angel Edwards
• Robert B Edwards, DDS
• Allyson Ann Epps
• Stonie Colt Ferrell
• Kyle Floyd, RN
• Gatesville Dental PLLC
• Gatesville Drug Company, LTD

• Orthopaedic Surgery of the Spine Physician in Gatesville, TX
• Providers in Gatesville, TX by specialty
• Orthopaedic Surgery of the Spine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.