Individual provider Active NPI

Christopher A Ellis, PA

  • Physician Assistant
  • Greeley, CO
National Provider Identifier
1952377665
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
947 Issued in CO
Practice address
1900 16TH St
Greeley, CO 80631-5114
Phone
(970) 350-2427
Fax
(970) 350-2421
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 947 CO Primary

Addresses

Primary practice location

1900 16TH St
Greeley, CO 80631-5114

Mailing address

1900 16TH St
Greeley, CO 80631-5114
Phone (970) 350-2427

Other identifiers 1

IdentifierTypeStateIssuer
07733054MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051110000272 CO Practitioner - Physician Assistant 1759309552 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

1100 E Prospect Rd
BLDG a
Fort Collins, CO 80525-5304
Phone (970) 297-6630

1106 E Prospect Rd
Building B Suite 100
Fort Collins, CO 80525-5304
Phone (970) 495-7410

1159 Eagle Dr
Urgent Care Eagle Drive
Loveland, CO 80537-8020
Phone (970) 219-5223

2127 E Harmony Rd
Suite 140 Uchmg Harmony Urgent Care
Fort Collins, CO 80528-3406
Phone (970) 297-6250

221 E 29TH St
Loveland, CO 80538-2746

4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260

4846 Larimer Pkwy
BLDG 1
Johnstown, CO 80534-9012
Phone (970) 624-2830

Hospital & facility affiliations

  • Poudre Valley Hospital Hospital, Fort Collins, CO, CCN 060010
  • Medical Center of the Rockies Hospital, Loveland, CO, CCN 060119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
947COMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Jul 11, 2011 Accepting new patients
North Colorado Emergency Physicians, PC Past Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

5965 Firestone Blvd
Bldg B
Firestone, CO 80504
Phone (720) 652-7055

2127 E Harmony Rd
Ste 140
Fort Collins, CO 80528
Phone (970) 207-4800

1100 E Prospect Rd
Fort Collins, CO 80525
Phone (970) 484-2850

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

2819 35th Ave
Greeley, CO 80634
Phone (970) 652-2801

6767 29th St
Fl 2
Greeley, CO 80634
Phone (970) 652-2433

1900 16th St
Greeley, CO 80631
Phone (970) 350-2438

5881 W 16th St
Ste A
Greeley, CO 80634
Phone (970) 313-2700

4846 Larimer Pkwy
Bldg 1
Johnstown, CO 80534
Phone (970) 624-2830

2101 Main St
Longmont, CO 80501
Phone (720) 745-8020

2500 Rocky Mountain Ave
Ste 2200
Loveland, CO 80538
Phone (970) 203-7250

3830 Grant Ave
Ste 200
Loveland, CO 80538

3830 Grant Ave
Loveland, CO 80538
Phone (970) 278-0807

221 E 29th St
Ste 105
Loveland, CO 80538
Phone (970) 776-3222

1159 Eagle Dr
Loveland, CO 80537
Phone (970) 219-5223

221 E 29th St
Ste 102
Loveland, CO 80538
Phone (970) 224-3636

Organizations & group practices 3

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1952377665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315114",
            "telephone_number": "970-350-2427",
            "fax_number": "970-350-2421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315114",
            "telephone_number": "970-350-2427",
            "fax_number": "970-350-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CHRISTOPHER",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "947",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07733054",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.