NPIMap

Organization Active NPI

John E Ellis

  • Eyewear Supplier
  • Connellsville, PA
National Provider Identifier
1649458308
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
OEG001091 Issued in PA
Legal business name
JOHN E ELLIS
Practice address
619 E Crawford Ave
Connellsville, PA 15425-2102
Phone
(724) 628-1370
Fax
(724) 628-7314
NPI assigned
Feb 5, 2008
Last updated
Oct 4, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Authorized official

Name
John E. Ellis, O.D.NPI 1962465971
Title
Owner
Phone
(724) 628-1370

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X OEG001091 PA Primary

Addresses

Primary practice location

619 E Crawford Ave
Connellsville, PA 15425-2102

Mailing address

619 E Crawford Ave
Connellsville, PA 15425-2102
Phone (724) 628-1370

National Provider Directory

National Provider Directory

Locations

619 E Crawford Ave
Connellsville, PA 15425
Phone (724) 628-1370

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349308800000",
    "number": "1649458308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 E CRAWFORD AVE",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154252102",
            "telephone_number": "724-628-1370",
            "fax_number": "724-628-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 E CRAWFORD AVE",
            "city": "CONNELLSVILLE",
            "state": "PA",
            "postal_code": "154252102",
            "telephone_number": "724-628-1370",
            "fax_number": "724-628-7314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN E ELLIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2012-10-04",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-628-1370",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "PA",
            "license": "OEG001091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Connellsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.