NPIMap

Organization Active NPI

Patrick B Ellis DO PC

  • Specialist
  • Norman, OK
National Provider Identifier
1659551752
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
3351 Issued in OK
Legal business name
PATRICK B ELLIS DO PC
Practice address
520 24TH Ave S.W.
Norman, OK 73069-5106
Phone
(405) 701-5666
Fax
(405) 701-5667
NPI assigned
Nov 6, 2007
Last updated
Sep 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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

Authorized official

Name
Dr. Patrick B. Ellis, D.O.NPI 1982636809
Title
Owner
Phone
(405) 701-5666

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
Specialist 174400000X 3351 OK Primary

Addresses

Primary practice location

520 24TH Ave S.W.
Norman, OK 73069-5106

Mailing address

520 24TH Ave S.W.
Norman, OK 73069-5106
Phone (405) 701-5666

Other identifiers 1

IdentifierTypeStateIssuer
100138180BMedicaidOK

National Provider Directory

National Provider Directory

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": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348185600000",
    "number": "1659551752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 24TH AVE S.W.",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730695106",
            "telephone_number": "405-701-5666",
            "fax_number": "405-701-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 24TH AVE S.W.",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730695106",
            "telephone_number": "405-701-5666",
            "fax_number": "405-701-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK B ELLIS DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2012-09-21",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-701-5666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "3351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100138180B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.