Ellis Pain & Pain Rehabilitation Center

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

9980 Issued in TX

Legal business name

ELLIS PAIN & PAIN REHABILITATION CENTER

Practice address

2200 W Ennis Ave
Suite # a
Ennis, TX 75119-8054

Phone

(972) 875-8600

NPI assigned

Jun 30, 2016

Last updated

Jun 30, 2016By 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

Jesus D Marcial, DCNPI 1407857915

Title

Managing Provider

Phone

(972) 875-8600

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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.

• Jesus Marcial, DC

  • Chiropractor
  • Ennis, TX
  • NPI 1407857915
  Authorized official Same address or phone

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467244800000",
    "number": "1780035774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 566455",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311566455",
            "fax_number": "770-504-5162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 W ENNIS AVE",
            "address_2": "SUITE # A",
            "city": "ENNIS",
            "state": "TX",
            "postal_code": "751198054",
            "telephone_number": "972-875-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS PAIN & PAIN REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A",
        "authorized_official_last_name": "MARCIAL",
        "authorized_official_first_name": "JESUS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING PROVIDER",
        "authorized_official_telephone_number": "972-875-8600",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "9980",
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "TX",
            "license": "10136",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edc Dental Center PLLC
• Ellis County Coalition for Health Options (Hope Clinic)
• Ellis County Medical Associates
• Ellis County Sleep Center, LLC
• Ellis Emergency Group PA
• Cody Ely
• Emmanuel E Sackey MD, PA (dba Ennis Childrens Clinic)
• Encompass Anesthesia Partners LLC
• Encore ASC, LLC
• Ennis Anesthesia Associates PLLC

• Rehabilitation Chiropractor in Ennis, TX
• Providers in Ennis, TX by specialty
• Rehabilitation Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.