David Michael Ellis, CPO

Primary specialty

ProsthetistTaxonomy code 224P00000X

Practice address

510 22ND Ave E
Suite# 801 Advance Orthotics & Prosthetics,
Alexandria, MN 56308-4653

Phone

(320) 762-2210

Fax

(320) 762-2753

NPI assigned

Sep 19, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Advance Orthotics & Prosthetics

  • Prosthetic/Orthotic Supplier
  • Alexandria, MN
  • NPI 1083899041

  Orthotist

  NPD Authorized official

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1720274129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 22ND AVE E",
            "address_2": "SUITE# 801 ADVANCE ORTHOTICS & PROSTHETICS,",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084653",
            "telephone_number": "320-762-2210",
            "fax_number": "320-762-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 22ND AVE E",
            "address_2": "SUITE# 801 ADVANCE ORTHOTICS & PROSTHETICS,",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563084653",
            "telephone_number": "320-762-2210",
            "fax_number": "320-762-2753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "CPO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Jane Eischens, AU.D.
• Lindsay Eisenmenger
• Richard D Eiser, M.D.
• Joshua Luther Eken, M.D.
• Ritajo Ellenberger
• Tim D Ellison
• Marcine P Ellwein, M.D.
• Tiffany Marie Emard
• John W Emblom, DO
• Brittany Emons

• Prosthetist in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Prosthetist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.