John Darris Ellis, PMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

PMFT-255 Issued in WY

Practice address

721 East 12200 South
Draper, UT 84040-8404

Phone

(801) 369-8989

Fax

(801) 704-9741

NPI assigned

Aug 1, 2012

Last updated

Feb 2, 2021By the provider in NPPES

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

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Numinus Wellness Ut Inc

  • Psychiatry Physician
  • Springville, UT
  • NPI 1265092282
  Medicare reassignment NPD
• Sequoia Family Therapy Services LLC

  dba Jellistherapy & Associates

  • Adult Mental Health Clinic/Center
  • Sandy, UT
  • NPI 1023425931
  NPD Authorized official
• Noetic Psychiatry, PLLC

  • Psychiatry Physician
  • Springville, UT
  • NPI 1679953756
  NPD
• Ogden Internal Medicine & Urology LLC

  • Internal Medicine Physician
  • Ogden, UT
  • NPI 1003001553
  NPD (past)

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

{
    "created_epoch": "1343779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1750637393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "672 W 400 S STE 201",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846633170",
            "telephone_number": "801-369-8989",
            "fax_number": "307-527-6218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 EAST 12200 SOUTH",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840408404",
            "telephone_number": "801-369-8989",
            "fax_number": "801-704-9741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Yellowstone behavioral Health 2538 Big Horn Ave",
            "address_2": "Cody Office",
            "address_purpose": "LOCATION",
            "city": "Cody",
            "state": "WY",
            "postal_code": "824149299",
            "country_code": "US",
            "telephone_number": "307-587-2197 x15",
            "fax_number": "307-587-7638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JOHN",
        "middle_name": "DARRIS",
        "credential": "PMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-01",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WY",
            "license": "PMFT-255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellie Kate Elggren
• Elite Carpal Tunnel LLC
• Elite Therapy Services LLC (FYZICAL Therapy and Balance Centers - Draper)
• Elite Tranquility Health Spa LLC (The spa lounge)
• Corbyn Ellertson
• Kaylyn Ellis, MOTR/L
• Kristy C Ellzey, ACMHC
• Emerge Treatment
• Emergency Physicians Group (Lone Peak Emergency)
• Empower You Therapy

• Marriage & Family Therapist in Draper, UT
• Providers in Draper, UT by specialty
• Marriage & Family Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.