Active NPI
David D Ellis
- Counselor
- Lynn, MA
National Provider Identifier
1518265479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 89 Linwood Rd
Lynn, MA 01905-1639 - Phone
- (781) 581-9515
- Fax
- (781) 581-9515
- NPI assigned
- Mar 2, 2011
- Last updated
- Mar 2, 2011
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | NU | Primary |
Addresses
Primary practice location
89 Linwood Rd
Lynn, MA 01905-1639
Mailing address
89 Linwood Rd
Lynn, MA 01905-1639
Phone (781) 581-9515
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299024000000",
"number": "1518265479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 LINWOOD RD",
"city": "LYNN",
"state": "MA",
"postal_code": "019051639",
"telephone_number": "781-581-9515",
"fax_number": "781-581-9515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 LINWOOD RD",
"city": "LYNN",
"state": "MA",
"postal_code": "019051639",
"telephone_number": "781-581-9515",
"fax_number": "781-581-9515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "DAVID",
"middle_name": "D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-03-02",
"last_updated": "2011-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.