John Ellis

Primary specialty

PharmacistTaxonomy code 183500000X

License

21089 Issued in IA

Practice address

923 N 1St St
Winterset, IA 50273-1231

Phone

(515) 971-4492

Fax

(515) 462-6739

NPI assigned

Apr 7, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1992334304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 N 1ST ST",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502731231",
            "telephone_number": "515-462-4299",
            "fax_number": "515-462-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 N 1ST ST",
            "city": "WINTERSET",
            "state": "IA",
            "postal_code": "502731231",
            "telephone_number": "515-971-4492",
            "fax_number": "515-462-6739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "923 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Winterset",
            "state": "IA",
            "postal_code": "502731231",
            "country_code": "US",
            "telephone_number": "515-462-4299",
            "fax_number": "515-462-6739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "21089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "1898pharmacymgr@hy-vee.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Hy-Vee Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "923 N 1st St",
            "city": "Winterset",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502731231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "1898pharmacymgr@hy-vee.com",
            "affiliation": "Y",
            "endpointDescription": "Email",
            "affiliationName": "Hy-Vee Inc",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "923 N 1st St",
            "city": "Winterset",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502731231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Winterset, IA
• Pharmacist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.