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JON M. ELLIS MD PA NPI 1740349661


NPI Information

NPI: 1740349661
Provider Name: JON M. ELLIS, MD PA

Doing Business As: SOUTHWEST SPORTS MEDICINE AND ORTHOPAEDICS

Classification: Orthopaedic Surgery - 207XX0005X
Entity Type: Organization

Specialization: Sports Medicine

CLIA Number: 45D2049854

Address:
7030 NEW SANGER RD
SUITE 200
WACO, TX
ZIP 76712
Phone: (254) 774-1140
Get Directions

JON M. ELLIS, MD PA is a sports medicine orthopaedic surgery in Waco, TX. The provider is an orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. JON M. ELLIS, MD PA NPI is 1740349661. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southwest Sports Medicine And Orthopaedics.

The provider's business location address is:

7030 NEW SANGER RD
SUITE 200
WACO, TX
ZIP 76712-991
Phone: (254) 774-1140
Fax: (254) 741-1428

The provider's authorized official is Matt Rohrer .
The authorized official title is Business Manager and has the following contact phone number (254) 741-1400.

The CLIA number assigned to this NPI record is 45D2049854 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/6/2006 and was last updated on 3/28/2008.


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 Taxonomy Specialization License Number License State Primary
1207XX0005XOrthopaedic SurgerySports MedicineJ9580TEXASYes

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
100447UMEDICARE PINTEXAS
2DB8538MEDICARE PINTEXAS

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.