John E Ellis

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

Organization subpart

No

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

Authorized official

Name

John E. Ellis, O.D.

Title

Owner

Phone

(724) 628-1370

Specialties & licenses 1

Addresses

Locations

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": []
}

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• Eyewear Supplier in Connellsville, PA
• Providers in Connellsville, PA by specialty
• Eyewear Supplier in Pennsylvania

• 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.