Organization Active NPI

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

  • Specialist
  • Alexandria, VA
National Provider Identifier
1861715435
Registry record updated Mar 10, 2010
On this page

Key facts

NPPES NPI Registry
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
Last updated
Mar 10, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2010

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

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X VA Primary

Addresses

Primary practice location

4660 Kenmore Ave
Suite 416
Alexandria, VA 22304-1313

Mailing address

1707 Osage St
Suite 205
Alexandria, VA 22302-2607
Phone (703) 578-0100

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

  • 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.