Active NPI
David Ellis, D.C.
- Rehabilitation Chiropractor
- Winnemucca, NV
National Provider Identifier
1609122480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- B01467
- Practice address
- 3200 Traders Way Ste C
Winnemucca, NV 89445-3683 - Phone
- (406) 459-5456
- NPI assigned
- Jul 30, 2012
- 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 |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | B01467 | NV | Primary |
Addresses
Primary practice location
3200 Traders Way Ste C
Winnemucca, NV 89445-3683
Mailing address
PO Box 2663
Winnemucca, NV 89446-2663
Phone (406) 459-5456
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3186 | WA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| High Desert Family Chiropractic, LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Chiropractor
- Winnemucca, NV
- NPI 1609291285
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1343606400000",
"number": "1609122480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2663",
"city": "WINNEMUCCA",
"state": "NV",
"postal_code": "894462663",
"telephone_number": "406-459-5456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 TRADERS WAY STE C",
"city": "WINNEMUCCA",
"state": "NV",
"postal_code": "894453683",
"telephone_number": "406-459-5456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "DAVID",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-07-30",
"last_updated": "2012-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "NV",
"license": "B01467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winnemucca, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.