NPIMap

Individual provider Active NPI

Mark R. Ellis, MD

  • Family Medicine Physician
  • Springfield, MO
National Provider Identifier
1982714804
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
103675 Issued in MO
Practice address
2900 S National Ave
Springfield, MO 65804-3634
Phone
(417) 269-1499
Fax
(417) 269-1459
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 103675 MO Primary

Addresses

Primary practice location

2900 S National Ave
Springfield, MO 65804-3634

Mailing address

PO Box 4046
Springfield, MO 65808-4046
Phone (417) 269-5712

Other identifiers 2

IdentifierTypeStateIssuer
121334OtherBLUE CROSS
208184820MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20050630000049 MO Practitioner - Family Practice 3375589302 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 5799787784, shared by 17 NPIs, 240 clinicians
Lester E Cox Medical CentersGroup PAC ID 1254248917, 336 clinicians
Cherry Health Center, LLCGroup PAC ID 1355317033, 97 clinicians

Practice addresses (Care Compare)

3525 E Battlefield St
Springfield, MO 65809-3434
Phone (417) 269-1499

510 Hwy 32
Suite B
Lebanon, MO 65536-5303
Phone (417) 533-0848

607 W Battlefield St
Springfield, MO 65807-4123
Phone (417) 869-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.78 of 100Reported as group
Quality
74.39
Promoting interoperability
100
Improvement activities
40
Cost
78.21

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers Family Medicine CurrentSince Oct 4, 2018 Accepting new patients
Lester E Cox Medical Centers Family Medicine Current Accepting new patients
Lester E. Cox Medical Centers Family Medicine Current Accepting new patients
Lester E Cox Medical Centers CurrentSince Sep 4, 2020 Accepting new patients
Lester E Cox Medical Centers Family Medicine CurrentSince Sep 4, 2020 Accepting new patients
Lester E Cox Medical Centers CurrentSince Jul 27, 2015 Accepting new patients
Lester E. Cox Medical Centers Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

3203 E Old Stone Ave
Brookline, MO 65619
Phone (417) 269-1910

1819 S National Ave
Springfield, MO 65804
Phone (417) 269-2700

3850 S National Ave
Ste 52
Springfield, MO 65807
Phone (417) 269-7878

1000 E Primrose St
Ste 360
Springfield, MO 65807
Phone (417) 269-4037

3850 S National Ave
Ste 520
Springfield, MO 65807
Phone (417) 269-7878

3800 S National Ave
Ste 700
Springfield, MO 65807
Phone (417) 269-8817

3800 S National Ave
Ste 540
Springfield, MO 65807
Phone (417) 269-6262

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

1423 N Jefferson Ave
Springfield, MO 65802
Phone (417) 269-6583

3801 S National Ave
Fl 5
Springfield, MO 65807

2750 S Campbell Ave
Springfield, MO 65807
Phone (417) 269-2281

2900 S National Ave
Springfield, MO 65804
Phone (417) 269-1499

3801 S National Ave
Ste 1122
Springfield, MO 65807

3525 E Battlefield St
Springfield, MO 65809
Phone (417) 269-0065

Interoperability endpoints

  • Direct secure messaging: mark.ellis@cernerdirect.coxhealth.com

Organizations & group practices 9

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 7

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1982714804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4046",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658084046",
            "telephone_number": "417-269-5712",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S NATIONAL AVE",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658043634",
            "telephone_number": "417-269-1499",
            "fax_number": "417-269-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MARK",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "103675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "121334",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208184820",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.