Individual provider Active NPI

Elizabeth A Ellington, PSYD

  • Clinical Psychologist
  • Dayton, OH
National Provider Identifier
1700267564
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7255 Issued in OH
Practice address
1159 Lyons Rd
Building E
Dayton, OH 45458-1857
Phone
(937) 558-0483
Fax
(937) 558-0565
NPI assigned
Jun 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7255 OH Primary

Addresses

Primary practice location

1159 Lyons Rd
Building E
Dayton, OH 45458-1857

Mailing address

1159 Lyons Rd
Building E
Dayton, OH 45458-1857
Phone (937) 558-0483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151013000746 OH Practitioner - Clinical Psychologist 2668785981 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Wright State University Boonshoft School of Medicine, 2011
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Farrellco, Inc.Group PAC ID 4284862707, 5 clinicians

Practice addresses (Care Compare)

1159 Lyons Rd E
Building E
Dayton, OH 45458-1857
Phone (937) 558-0483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1700267564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 LYONS RD",
            "address_2": "BUILDING E",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581857",
            "telephone_number": "937-558-0483",
            "fax_number": "937-558-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 LYONS RD",
            "address_2": "BUILDING E",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454581857",
            "telephone_number": "937-558-0483",
            "fax_number": "937-558-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGTON",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "7255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.