James Wade Elliott, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

010652 Issued in MO

Practice address

1 E Broadway
Columbia, MO 65203-4205

Phone

(573) 449-2858

NPI assigned

Nov 7, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730258153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 BAYONNE CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652031407",
            "telephone_number": "573-445-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E BROADWAY",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652034205",
            "telephone_number": "573-449-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "JAMES",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "010652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb D Ellenburg, DO
• Billy R Elliott, OPA-C
• Darren Elliott, CRNA
• Jacie Elliott, DPT
• James T Elliott, M.D.
• Thomas A Elliott, DDS
• Carrie Ellis-Crnkovich, MSW,LICSW
• Jacqueline A Ellis, PHD
• Kayla Ellis
• Kellie Rae Ellyson, PHARMD

• General Practice Dentistry in Columbia, MO
• Providers in Columbia, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.