NPIMap

Organization Active NPI

Ellis Pediatrics

Doing business as North Austin Pediatrics, P.A.

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1790932259
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K2457 Issued in TX
Legal business name
ELLIS PEDIATRICS
Doing business as
North Austin Pediatrics, P.A.
Practice address
12201 Renfert Way
Suite 110
Austin, TX 78758-5354
Phone
(512) 491-5125
Fax
(512) 491-8521
NPI assigned
Aug 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leighton Elizabeth Ellis, M.D.NPI 1457322760
Title
Owner/President
Phone
(512) 491-5125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X K2457 TX Primary

Addresses

Primary practice location

12201 Renfert Way
Suite 110
Austin, TX 78758-5354

Mailing address

12201 Renfert Way
Suite 110
Austin, TX 78758-5354
Phone (512) 491-5125

Other names 1

  • North Austin Pediatrics, P.A. Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0931523Ellis Pediatrics PA12201 Renfert Way Suite 110, Austin, TX 78758Certificate of waiverJul 29, 2027

National Provider Directory

National Provider Directory

Locations

12201 Renfert Way
Ste 110
Austin, TX 78758
Phone (512) 491-5125

709 N Bagdad Rd
Leander, TX 78641

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1790932259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 RENFERT WAY",
            "address_2": "SUITE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585354",
            "telephone_number": "512-491-5125",
            "fax_number": "512-491-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12201 RENFERT WAY",
            "address_2": "SUITE 110",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585354",
            "telephone_number": "512-491-5125",
            "fax_number": "512-491-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-26",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "LEIGHTON",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "512-491-5125",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K2457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Austin Pediatrics, P.A.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.