NPIMap

Organization Active NPI

Christian Ellis MD PLC

  • Clinic/Center
  • Naples, FL
National Provider Identifier
1629338736
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
ME101183 Issued in FL
Legal business name
CHRISTIAN ELLIS MD PLC
Practice address
11181 Health Park Blvd Ste 1170
Naples, FL 34110-5734
Phone
(239) 596-8814
NPI assigned
May 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Authorized official

Name
Christian Ellis, MDNPI 1477724888
Title
Medical Director
Phone
(239) 404-6641

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X ME101183 FL Primary

Addresses

Primary practice location

11181 Health Park Blvd Ste 1170
Naples, FL 34110-5734

Mailing address

300 Dunes Blvd Apt 704
Naples, FL 34110-6438
Phone (239) 404-6641

National Provider Directory

National Provider Directory

Locations

11181 Health Park Blvd
Ste 1170
Naples, FL 34110
Phone (239) 514-7315

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1629338736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 DUNES BLVD APT 704",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341106438",
            "telephone_number": "239-404-6641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11181 HEALTH PARK BLVD STE 1170",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341105734",
            "telephone_number": "239-596-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN ELLIS MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "239-404-6641",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "ME101183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.

Verify at the official NPI Registry.