Robert Stanfill Ellison, MD, MPH

Primary specialty

SpecialistTaxonomy code 174400000X

License

28181 Issued in NC

Practice address

614 Howard Street
Asu Student Health Service
Boone, NC 28607

Phone

(828) 262-3100

Fax

(828) 262-6262

NPI assigned

Aug 30, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Appalachian State University

  • Student Health Clinic/Center
  • Boone, NC
  • NPI 1891815908
  NPD (past)
• Appalachian State University Student Health Services

  • Student Health Clinic/Center
  • Boone, NC
  • NPI 1376522821
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1841309762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32070",
            "address_2": "614 HOWARD STREET",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286082070",
            "telephone_number": "828-262-3100",
            "fax_number": "828-262-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 HOWARD STREET",
            "address_2": "ASU STUDENT HEALTH SERVICE",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "28607",
            "telephone_number": "828-262-3100",
            "fax_number": "828-262-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "ROBERT",
        "middle_name": "STANFILL",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "28181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3404395",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward D Elliott, DIPL.AC., L.AC.
• Jessica Lyndall Elliott, FNP
• Josey Elliott, RBT
• Brenda Ellis, PHARMD
• James W Ellis Jr., DR
• Embrace Therapy Services PLLC
• Emily Stopper, DDS, PLLC
• Tucker Gilbert Ensley, PHARMD
• Jessica M Espada, LPC , NCC
• Joel Ess, LCSW

• Specialist in Boone, NC
• Providers in Boone, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.