Organization Active NPI

Ellyson Chiropractic Corporation

  • Chiropractor
  • Marysville, CA
National Provider Identifier
1740310432
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
29423 Issued in CA
Legal business name
ELLYSON CHIROPRACTIC CORPORATION
Practice address
605 E Street
Marysville, CA 95901
Phone
(530) 743-2093
Fax
(530) 743-3301
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Authorized official

Name
Dr. David S Ellyson, DCNPI 1497951636
Title
Director
Phone
(530) 743-2093

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 29423 CA Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 29895 CA
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 11189 CA

Addresses

Primary practice location

605 E Street
Marysville, CA 95901

Mailing address

605 E Street
Marysville, CA 95901
Phone (530) 743-2093

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050526001039 CA Part B Supplier - Clinic/Group Practice 8820030083 Receives reassigned benefits from 2 practitioners
Practice locations: Marysville, CA

National Provider Directory

National Provider Directory

Locations

605 E St
Marysville, CA 95901
Phone (530) 743-2093

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1740310432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 E STREET",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "95901",
            "telephone_number": "530-743-2093",
            "fax_number": "530-743-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 E STREET",
            "city": "MARYSVILLE",
            "state": "CA",
            "postal_code": "95901",
            "telephone_number": "530-743-2093",
            "fax_number": "530-743-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLYSON CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "ELLYSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "530-743-2093",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "29423",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "29895",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "11189",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.