Individual provider Active NPI

Danielle Erwin Ellis, O.D.

  • Optometrist
  • Coshocton, OH
National Provider Identifier
1588951636
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6035 Issued in OH
Practice address
535 Chestnut St
Coshocton, OH 43812-1210
Phone
(740) 622-2270
Fax
(740) 622-4376
NPI assigned
Jul 8, 2011
Last updated
Apr 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 6035 OH Primary

Addresses

Primary practice location

535 Chestnut St
Coshocton, OH 43812-1210

Mailing address

535 Chestnut St
Coshocton, OH 43812-1210
Phone (740) 622-2270

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110919000569 OH Practitioner - Optometry 1658542907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dr David a Erwin and Associates IncGroup PAC ID 1254458235, 2 clinicians

Practice addresses (Care Compare)

535 Chestnut St
Coshocton, OH 43812-1210
Phone (740) 622-2270

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6035OHMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr David a Erwin and Associates Inc Optometrist CurrentSince Nov 16, 2011 Accepting new patients

Locations

535 Chestnut St
Coshocton, OH 43812
Phone (740) 622-2270

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1588951636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 CHESTNUT ST",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121210",
            "telephone_number": "740-622-2270",
            "fax_number": "740-622-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 CHESTNUT ST",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121210",
            "telephone_number": "740-622-2270",
            "fax_number": "740-622-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "DANIELLE",
        "middle_name": "ERWIN",
        "name_prefix": "Mrs.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "6035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coshocton, OH

Sources for this page

Verify at the official NPI Registry.