Jon M. Ellis, MD PA

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

J9580 Issued in TX

Legal business name

JON M. ELLIS, MD PA

Doing business as

Southwest Sports Medicine and Orthopaedics

Practice address

7030 New Sanger Rd
Suite 200
Waco, TX 76712-3991

Phone

(254) 774-1140

Fax

(254) 741-1428

NPI assigned

Dec 6, 2006

Last updated

Mar 28, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Matt Rohrer

Title

Business Manager

Phone

(254) 741-1400

Specialties & licenses 1

Addresses

Other names 1

• Southwest Sports Medicine and Orthopaedics Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Edward Haynes, MD

  • Orthopaedic Surgery Physician
  • Waco, TX
  • NPI 1811995038
  NPD (past)
• Christopher Wayne Miars, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Waco, TX
  • NPI 1194794537
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1740349661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7030 NEW SANGER RD",
            "address_2": "SUITE 200",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123991",
            "telephone_number": "254-774-1140",
            "fax_number": "254-741-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7030 NEW SANGER RD",
            "address_2": "SUITE 200",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123991",
            "telephone_number": "254-774-1140",
            "fax_number": "254-741-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JON M. ELLIS, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "ROHRER",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "254-741-1400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TX",
            "license": "J9580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southwest Sports Medicine and Orthopaedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trasaudia Johnson
• Tyler Keith Johnson, APRN
• Joshua Kole Johnston
• Jason Lafayette Jolivet, DDS
• Janet M Jolly, CFNP
• Jonathan G Wash DPM PA
• Alexandra Marie Jones Adesina
• Clinton Michael Jones, DO
• Erika Marie Jones, O.D.
• Fallon Jones, MA, LPC

• Sports Medicine (Orthopaedic Surgery) Physician in Waco, TX
• Providers in Waco, TX by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2008; 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.