Individual provider Active NPI

Samuel Lee Ellis, PHARM.D., CDE, BCPS

  • Pharmacotherapy Pharmacist
  • Denver, CO
National Provider Identifier
1730188624
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
15271 Issued in CO
Practice address
4200 East Ninth Ave
C238
Denver, CO 80262-0001
Phone
(303) 315-1132
Fax
(303) 315-4630
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacotherapy Pharmacist 1835P1200X 15271 CO Primary

Addresses

Primary practice location

4200 East Ninth Ave
C238
Denver, CO 80262-0001

Mailing address

2083 Glencoe St
Denver, CO 80207-3832
Phone (303) 315-1132

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
15271COMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1730188624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2083 GLENCOE ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802073832",
            "telephone_number": "303-315-1132",
            "fax_number": "303-315-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 EAST NINTH AVE",
            "address_2": "C238",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802620001",
            "telephone_number": "303-315-1132",
            "fax_number": "303-315-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SAMUEL",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., CDE, BCPS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "CO",
            "license": "15271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.