Active NPI
Dana Depaul Ellis, L.AC
- Acupuncturist
- Bryn Mawr, PA
National Provider Identifier
1679143077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AK001144
- Practice address
- 32 Summit Grove Ave
Bryn Mawr, PA 19010-3212 - Phone
- (484) 362-9171
- NPI assigned
- Jun 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | AK001144 | PA | Primary |
Addresses
Primary practice location
32 Summit Grove Ave
Bryn Mawr, PA 19010-3212
Mailing address
2523 Belmont Ave
Ardmore, PA 19003-2616
Phone (202) 315-8283
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AK001144 | PA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624838400000",
"number": "1679143077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2523 BELMONT AVE",
"city": "ARDMORE",
"state": "PA",
"postal_code": "190032616",
"telephone_number": "202-315-8283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "32 SUMMIT GROVE AVE",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103212",
"telephone_number": "484-362-9171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "DANA",
"middle_name": "DEPAUL",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-28",
"last_updated": "2021-06-28",
"certification_date": "2021-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "PA",
"license": "AK001144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bryn Mawr, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.