Gregory Lee Ellison, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD12426 Issued in AZ

Practice address

2127 E Baseline Rd Ste 104
Tempe, AZ 85283-1537

Phone

(480) 897-7070

Fax

(480) 897-2597

NPI assigned

Oct 4, 2006

Last updated

May 21, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arizona Family Physicians

  • Family Medicine Physician
  • Tempe, AZ
  • NPI 1003955832
  Authorized official Same address or phone

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1669567434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2127 E BASELINE RD STE 104",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831537",
            "telephone_number": "480-897-7070",
            "fax_number": "480-897-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 E BASELINE RD STE 104",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831537",
            "telephone_number": "480-897-7070",
            "fax_number": "480-897-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "GREGORY",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "MD12426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080055004",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214510",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0006680",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Elliott
• Christine Marie Elliott, M.S., CCC-SP.
• Sanya Elise Elliott
• Karen E Ellis, FNP
• Nicole Ellis, LCSW
• Stephanie Ellman, DDS, MS
• Melissa Ells, NURSE
• Asheeki Elmore, PSYD
• Marwan Gamal Elmubarak
• Sally Elrayah

• Family Medicine Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.