NPIMap

Individual provider Active NPI

Chaston J Ellis, DO

  • Psychiatry Physician
  • Salt Lake City, UT
National Provider Identifier
1891373312
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
12994417-1204 Issued in UT
Practice address
501 S Chipeta Way
Salt Lake City, UT 84108-1222
Phone
(801) 581-7951
NPI assigned
Mar 29, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 12994417-1204 UT Primary

Addresses

Primary practice location

501 S Chipeta Way
Salt Lake City, UT 84108-1222

Mailing address

501 S Chipeta Way
Salt Lake City, UT 84108-1222
Phone (801) 581-7951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251111000518 SD Practitioner - Psychiatry 0345624664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

915 Mountain View Rd
Rapid City, SD 57702-3414
Phone (605) 755-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
12994417-1204UTMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital, Inc CurrentSince Sep 1, 2025 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Sep 1, 2025 Accepting new patients
Monument Health Rapid City Hospital, Inc. Past Accepting new patients
Idaho State University Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

915 Mountain View Rd
Rapid City, SD 57702
Phone (605) 719-7200

Interoperability endpoints

  • Direct secure messaging: cellis492807@ahs.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1891373312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S CHIPETA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081222",
            "telephone_number": "801-581-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S CHIPETA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081222",
            "telephone_number": "801-581-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CHASTON",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "UT",
            "license": "12994417-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.