Active NPI
Robert A Ellers, SCHOOL PSYCHOLOGIST
- School Psychologist
- Marana, AZ
National Provider Identifier
1750546271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 4040404
- Practice address
- 12279 W. Grier Rd.
Marana, AZ 85653 - Phone
- (520) 682-4782
- Fax
- (520) 682-4818
- NPI assigned
- Jul 24, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 4040404 | AZ | Primary |
Addresses
Primary practice location
12279 W. Grier Rd.
Marana, AZ 85653
Mailing address
12755 N New Reflection Dr
Marana, AZ 85658-4395
Phone (520) 572-4248
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4040404 | AZ | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216857600000",
"number": "1750546271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12755 N NEW REFLECTION DR",
"city": "MARANA",
"state": "AZ",
"postal_code": "856584395",
"telephone_number": "520-572-4248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12279 W. GRIER RD.",
"city": "MARANA",
"state": "AZ",
"postal_code": "85653",
"telephone_number": "520-682-4782",
"fax_number": "520-682-4818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLERS",
"first_name": "ROBERT",
"middle_name": "A",
"credential": "SCHOOL PSYCHOLOGIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-24",
"last_updated": "2008-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "AZ",
"license": "4040404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marana, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.