Roger M Ellis, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5693956-1202 Issued in UT

Practice address

990 Medical Dr Ste Ul-1
Brigham City, UT 84302-4713

Phone

(435) 723-2311

Fax

(435) 723-9706

NPI assigned

Oct 18, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in UT

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sports and Family Chiropractic Group PCGroup PAC ID 7517850936, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sports & Family Chiropractic Group PC

  • Chiropractor
  • Brigham City, UT
  • NPI 1760690465
  Medicare reassignment Care Compare group NPD
• Freeland Chiropractic PLLC

  • Chiropractor
  • Clearfield, UT
  • NPI 1679747919
  NPD (past)

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740361435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 MEDICAL DR STE UL-1",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843024713",
            "telephone_number": "435-723-2311",
            "fax_number": "435-723-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 MEDICAL DR STE UL-1",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843024713",
            "telephone_number": "435-723-2311",
            "fax_number": "435-723-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ROGER",
        "middle_name": "M",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "5693956-1202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary John Egan
• Curtis Egbert
• Kesiah Elison
• Elite PT and Sports Rehab
• Laura Jane Ellis
• Encore, L.C.
• Jeffrey England
• Jori England
• Ensign Assisted Living LLC (Gables of Brigham City)
• Alexandria Esplin

• Chiropractor in Brigham City, UT
• Providers in Brigham City, UT by specialty
• Chiropractor in Utah

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.