Demetrius J Ellis I

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2001 S Garnett Rd Ste G
Tulsa, OK 74128-1838

Phone

(918) 878-7877

Fax

(918) 878-7882

NPI assigned

Feb 24, 2014

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1780009027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5201 S WESTERN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731094526",
            "telephone_number": "405-632-0870",
            "fax_number": "918-878-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S GARNETT RD STE G",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741281838",
            "telephone_number": "918-878-7877",
            "fax_number": "918-878-7882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "DEMETRIUS",
        "middle_name": "J",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-24",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Ellis-Rapson
• Brittany Kay Degen Ellis, DMD
• Chasity Ellis
• Daniel K Ellis, D.O.
• Debbie Leigh Ellis
• Jennifer Shermaine Ellis
• Kenzie Ellis, RN,BSN,IBCLC
• Larry L Ellis, DO
• Nanette Ellis
• Robert George Ellis, M.D.

• Case Manager/Care Coordinator in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.