Nicholas Ellyn, M.D., P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

NICHOLAS ELLYN, M.D., P.C.

Practice address

4660 Kenmore Ave
Suite 416
Alexandria, VA 22304-1313

Phone

(703) 751-0700

NPI assigned

Mar 10, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas Ellyn, M.D.NPI 1174626311

Title

Physician

Phone

(703) 578-0100

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Nicholas Ellyn, M.D.

  • Ophthalmology Physician
  • Alexandria, VA
  • NPI 1174626311
  NPD (past) Authorized official

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1861715435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1707 OSAGE ST",
            "address_2": "SUITE 205",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223022607",
            "telephone_number": "703-578-0100",
            "fax_number": "703-824-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 KENMORE AVE",
            "address_2": "SUITE 416",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223041313",
            "telephone_number": "703-751-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLAS ELLYN, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2010-03-10",
        "status": "A",
        "authorized_official_last_name": "ELLYN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "703-578-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1174626311",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6380883",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ngoc Xuan Nguyen, PHARMD
• Trach N Nguyen, M.D.
• Tram-Anh Nguyen, PHARMD.
• Tuong-Van Nguyen
• Nicholas Ellyn, M.D., P.C.
• Caitlyn Elizabeth Nicholas, LCSW
• Elizabeth Lee Dye Nichols, LPC
• Dorothy Mary Nicholson, M.D.
• Rachel M Nicholson
• Nick Medical Transport LLC

• Specialist in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.