Jason Lee Ellis, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4989 Issued in MN

Practice address

7250 France Ave S.
300 A
Edina, MN 55435-4346

Phone

(952) 835-4772

Fax

(763) 207-8381

NPI assigned

Feb 28, 2007

Last updated

Oct 13, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Vitality Life Chiropractic, LLC

  • Chiropractor
  • Edina, MN
  • NPI 1992216295
  Authorized official Same address or phone
• Vitality Life Chiropractic, LLC

  • Chiropractor
  • Edina, MN
  • NPI 1992988216
  Authorized official Same address or phone

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507852800000",
    "number": "1700914140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7250 FRANCE AVE S",
            "address_2": "300A",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354313",
            "telephone_number": "952-835-4772",
            "fax_number": "763-207-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7250 FRANCE AVE S.",
            "address_2": "300 A",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354346",
            "telephone_number": "952-835-4772",
            "fax_number": "763-207-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JASON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2017-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4989",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009298",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3I335EL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROCARE",
            "identifier": "CC1343A",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "716650",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Marie Ellingson, M.D.
• Angela Goldie Elliott, CNP
• Michael Steven Elliott, M.D.
• Amanda Ellis, LICSW
• Breanna Nicole Ellis, PT
• Mark L. Ellis, MD
• Christine Marie Ellison, CNP
• Denae Ellson, MS, WHNP-BC, CNM
• David Carl Elmeer, MD
• Elmflex LLC

• Chiropractor in Edina, MN
• Providers in Edina, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2017; 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.