Mark Ellis

Primary specialty

PharmacistTaxonomy code 183500000X

License

6745 Issued in SC

Practice address

10048 Charlotte Hwy
Indian Land, SC 29707-7135

Phone

(803) 802-1818

NPI assigned

Jan 22, 2015

Last updated

Jan 26, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mark Ellis Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1902295389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10048 CHARLOTTE HWY",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297077135",
            "telephone_number": "803-802-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10048 CHARLOTTE HWY",
            "city": "INDIAN LAND",
            "state": "SC",
            "postal_code": "297077135",
            "telephone_number": "803-802-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MARK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-22",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "6745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "ELLIS",
            "credential": "R.PH.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Pharmacist in Indian Land, SC
• Providers in Indian Land, SC by specialty
• Pharmacist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.