Kenneth Ross Ellul, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104557616 Issued in VA

Practice address

2236 General Booth Blvd Ste 110
Virginia Beach, VA 23456-4092

Phone

(757) 918-7761

Fax

(757) 689-3597

NPI assigned

Oct 29, 2019

Sex

Male

Sole proprietor

No

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 VA, IL2 enrollments

Enrollment records 2

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Koah Chiropractic LLC

  dba KOAH Chiropractic

  • Chiropractor
  • Romeoville, IL
  • NPI 1316773666
  Medicare reassignment NPD Authorized official
• Integrative Health Associates, LTD

  • Chiropractor
  • Romeoville, IL
  • NPI 1083828230
  NPD (past)

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1831733310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2236 GENERAL BOOTH BLVD STE 110",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234564092",
            "telephone_number": "757-918-7761",
            "fax_number": "757-689-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2236 GENERAL BOOTH BLVD STE 110",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234564092",
            "telephone_number": "757-918-7761",
            "fax_number": "757-689-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLUL",
        "first_name": "KENNETH",
        "middle_name": "ROSS",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-29",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca McLain Ellis, DPT
• Sara Ellis
• Cynthia Sherron Ellison, L.P.C.
• Traci Harp Ellison, PA-C
• Angelique Ellorin, BS, RBT, QMHP-T
• Danielle Elm
• Sara Elsiddig, DDS
• Morris M Elstein, M.D.
• Nickolas Lee Ely
• Elysian Health LLC (Elysian Wellness)

• Chiropractor in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.