DR. JIMMY SCOTT ELLIS D.O. NPI 1609891795

NPI Information

NPI: 1609891795
Provider Name: DR. JIMMY SCOTT ELLIS, D.O.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
785 RUSSELL ST
SUITE 100
CRAIG, CO
ZIP 81625
Phone: (970) 826-2420
Get Directions

DR. Jimmy Scott Ellis, D.O. is an obstetrics gynecology in Craig, CO. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. DR. Jimmy Scott Ellis, D.O. NPI is 1609891795. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

785 RUSSELL ST
SUITE 100
CRAIG, CO
ZIP 81625-019
Phone: (970) 826-2420
Fax: (970) 826-2429

The NPI 1609891795 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/12/2006 and was last updated on 10/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	207V00000X	Obstetrics & Gynecology	L6229	TEXAS	No
2	207V00000X	Obstetrics & Gynecology	OP61014771	WASHINGTON	No
3	207V00000X	Obstetrics & Gynecology	46656	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	159097801	MEDICAID	TEXAS
2	7431448	OTHER		AETNA
3	P00070099	OTHER	TEXAS	RAILROAD MEDICARE
4	3277999	OTHER		CIGNA
5	8J3940	OTHER	TEXAS	BCBS
6	01936531	MEDICAID	COLORADO
7	133125100	OTHER		FIRSTCARE & SW LIFE&HEALT
8	311819386790650000	OTHER		TRICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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