Ellis Medical Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ELLIS MEDICAL CLINIC LLC

Practice address

814 Jefferson St
Ellis, KS 67637-2215

Phone

(785) 520-5020

Fax

(785) 520-5025

NPI assigned

Dec 6, 2018

Last updated

Feb 16, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christy Dawn Cunningham

Title

Business Manager

Phone

(785) 520-5020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Harley E Calvin, D.O.

  • Family Medicine Physician
  • Wichita, KS
  • NPI 1124066451
  Medicare reassignment NPD

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550275200000",
    "number": "1871064568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 174",
            "city": "ELLIS",
            "state": "KS",
            "postal_code": "676370174",
            "telephone_number": "785-259-4261",
            "fax_number": "785-520-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 JEFFERSON ST",
            "city": "ELLIS",
            "state": "KS",
            "postal_code": "676372215",
            "telephone_number": "785-520-5020",
            "fax_number": "785-520-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIS MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-06",
        "last_updated": "2019-02-16",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "785-520-5020"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Baker, DOULA, CFP
• Amy L Church, PTA
• Davis Physical Therapy LLC
• Aura L Davis, OTA
• Kayle Sue Eastes
• Ellis Usd 388
• Jessica Feldt, M.S., CCC/L-SLP
• Robert Givens
• Healthcare Professional Equipment Services
• Jerry Pfeifer Independent Case Management, LLC

• Family Medicine Physician in Ellis, KS
• Providers in Ellis, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.