Elaine M Ellis, M.D.

Primary specialty

Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X

License

33938 Issued in AZ

Practice address

10210 N 92ND St
Suite 207
Scottsdale, AZ 85258-4509

Phone

(480) 661-1332

Fax

(480) 661-1364

NPI assigned

Apr 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282694400000",
    "number": "1952364150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4722 N 24TH ST",
            "address_2": "STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164800",
            "telephone_number": "602-256-4628",
            "fax_number": "602-957-9438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10210 N 92ND ST",
            "address_2": "SUITE 207",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584509",
            "telephone_number": "480-661-1332",
            "fax_number": "480-661-1364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ELAINE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2010-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "AZ",
            "license": "33938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "953142",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Elliot
• Kathryn Elliott-Hudson, MED. ,LISAC, NCGC-II
• Kendra Elliott, CRNA
• Matthew Elliott, RD
• Amanda Christian Ellis, NMD
• Kate Ellis, CLINICAL COUNSELING
• Paige Kathryn Ellis, SLP
• Wendy Ellis, M.C., L.P.C.
• Jessica T Ellsworth, M.D.
• Richard Lee Ellsworth, COTA/L

• Pediatric Neurodevelopmental Disabilities Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Pediatric Neurodevelopmental Disabilities Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.