Active NPI
William G. Ellis II
- Student in an Organized Health Care Education/Training Program
- Haverhill, MA
National Provider Identifier
1841508439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- S72733820
- Practice address
- 60 Merrimack St
Haverhill, MA 01830-6207 - Phone
- (978) 457-3066
- NPI assigned
- Sep 17, 2010
- Last updated
- Sep 17, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | S72733820 | MA | Primary |
Addresses
Primary practice location
60 Merrimack St
Haverhill, MA 01830-6207
Mailing address
60 Merrimack Street
Haverhill, MA 01830
Phone (978) 457-3066
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S72733820 | MA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284681600000",
"number": "1841508439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 MERRIMACK STREET",
"city": "HAVERHILL",
"state": "MA",
"postal_code": "01830",
"telephone_number": "978-457-3066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 MERRIMACK ST",
"city": "HAVERHILL",
"state": "MA",
"postal_code": "018306207",
"telephone_number": "978-457-3066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "WILLIAM",
"middle_name": "G.",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-17",
"last_updated": "2010-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MA",
"license": "S72733820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haverhill, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.