DR. KENNETH K ELLIS (NPI# 1114902228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114902228 |
| Entity Type | Individual |
| Full Name | DR. KENNETH K ELLIS |
| Credential | M.D. |
| Practice Address |
11111 Research Blvd Suite 390 Austin TX 78759-5264 |
| Mailing Address |
Po Box 10597 Austin TX 78766-1597 |
| Practice Telephone | 5122442273 |
| Practice Fax Number | 5126717883 |
| Mailing Telephone | 5124855878 |
| Mailing Fax Number | 5124200397 |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2008-02-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
H9203 | TX | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154403210 | Kenneth Nickolas Ellis | Dentist | 7995 Bellfort St, Houston, TX 77061-1960 | 2006-10-19 |
| 1417973850 | Kenneth J Ellis | Psychologist | 1106 Columbia Ave, Suite 100, Marysville, WA 98270-4335 | 2006-07-15 |
| 1215981022 | Kenneth R Ellis | Ophthalmology | 1213 24th St, Suite 300, Anacortes, WA 98221-2592 | 2006-05-19 |
| 1447248133 | Kenneth Ellis | Anesthesiology | 1099 Augusta Falls Way, Naples, FL 34119-1362 | 2005-10-07 |
| 1992212633 | Kenneth Ellis | Case Manager/Care Coordinator | 1802 Hwy 82 West, Crossett, AR 71635 | 2018-01-03 |
| 1700103934 | Kenneth Ray Ellis | Specialist | 2243 Eddie Williams Rd, Johnson City, TN 37601-2872 | 2010-04-28 |
| 1215017694 | Kenneth R Ellis | Psychologist | 5525 Twin Knolls Rd, Suite 327, Columbia, MD 21045-3266 | 2006-10-17 |
| Street Address |
11111 RESEARCH BLVD SUITE 390 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78759-5264 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376545186 | Marsha Hillary Onan | Ophthalmology | 11111 Research Blvd, Suite 220, Austin, TX 78759-5264 | 2005-08-11 |
| 1639500465 | Kathryn Ruth Shirley | Nurse Practitioner | 11111 Research Blvd, Ll2, Austin, TX 78759-5264 | 2013-12-04 |
| 1528309739 | Angela Michelle Pena | Nurse Practitioner | 11111 Research Blvd, Ll2, Austin, TX 78759-5264 | 2013-03-13 |
| 1235484957 | Maeturah Zoe Harmon | Obstetrics & Gynecology | 11111 Research Blvd, Suite 230, Austin, TX 78759-5264 | 2012-07-18 |
| 1679851901 | Deirdre M Rhoad M D P A | Specialist | 11111 Research Blvd, Suite 310, Austin, TX 78759-5264 | 2011-08-04 |
| 1225336274 | Cynthia Chaparro-krueger | Obstetrics & Gynecology | 11111 Research Blvd, Suite 230, Austin, TX 78759-5264 | 2011-02-28 |
| 1568769032 | Kellie M Barrett | Physician Assistant | 11111 Research Blvd, 300, Austin, TX 78759-5264 | 2011-02-18 |
| 1104139575 | Cardiovascular Associates Northwest Pllc | Nuclear Medicine | 11111 Research Blvd, Suite 360, Austin, TX 78759-5264 | 2010-07-14 |
| 1790010585 | Austin Texas Radiation Oncology Group, Pa | Specialist | 11111 Research Blvd, Austin, TX 78759-5264 | 2009-10-12 |
| 1679711279 | Peter Jeffrey Gembol | Nurse Practitioner | 11111 Research Blvd, Ste 310, Austin, TX 78759-5264 | 2009-02-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629677612 | Laurel Sunde | Nurse Practitioner | 11111 Research Blvd-ll2, Austin, TX 78759 | 2020-10-20 |
| 1558990242 | Sarah Ann Weier | Counselor | 8500 North Mopac Expressway, Austin, TX 78759 | 2020-04-03 |
| 1124672696 | Gabrielle Jade Hurley | Physical Therapist | 9333 Research Blvd Ste 400, Austin, TX 78759 | 2019-08-01 |
| 1730740671 | Jennifer Kraft | Behavior Technician | 9600 Great Hills Trail, Suite 150w, Austin, TX 78759 | 2019-06-21 |
| 1881199024 | Pediatric Home Healthcare, LLC | Home Health | 8501 N Mopac Expy Ste 410, Austin, TX 78759 | 2018-03-29 |
| 1679072870 | Sylvia Chen | Psychologist | 8400 N Mopac Expy Ste 302, Austin, TX 78759 | 2018-02-03 |
| 1215443064 | Greater Austin Urology, Pllc | Urology | 11673 Jollyville Rd Ste B101, Austin, TX 78759 | 2017-12-15 |
| 1831603042 | Jane A Dykes | Counselor | 9015 Mountain Ridge Dr., Houston Bldg., Ste. 200, Austin, TX 78759 | 2017-11-27 |
| 1134632706 | Gary Victor Friedman | Pharmacist | 4411 Spicewood Springs Road #1111, Austin, TN 78759 | 2017-11-06 |
| 1740720242 | Taylor Renee Cahill | Behavioral Analyst | 9901 North Capital of Texas Hwy, Austin, TX 78759 | 2017-03-02 |
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| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023348299 | Praveen Kumar Sampath | Internal Medicine | 12201 Renfert Way Ste 315, Austin, TX 78758 | 2010-01-11 |
| 1104086628 | Harry J Thomas | Internal Medicine | 1111 W 34th St Ste 200, Austin, TX 78705-1916 | 2008-06-10 |
| 1548376312 | Syed M.a. Rizvi | Internal Medicine | 12701 Rr 620 N Ste 101, Austin, TX 78750-1141 | 2006-08-22 |
| 1902822281 | Nadege Tacha Gunn | Internal Medicine | 3001 Bee Caves Rd Ste 220, Austin, TX 78746-5590 | 2006-07-13 |
| 1841276748 | George Edward Kitzmiller | Internal Medicine | 4507 Crestway Dr, Austin, TX 78731-5201 | 2005-12-22 |
| 1932184512 | Angel Eduardo Alcocer | Internal Medicine | 1111 W 34th St, Suite 200, Austin, TX 78705-1900 | 2005-12-07 |
| 1508841180 | Frank B Adams | Internal Medicine | 5700 Standing Rock Dr, Austin, TX 78730-2859 | 2005-12-07 |
| 1548245079 | William Stassen | Internal Medicine | 8015 Shoal Creek Blvd Ste 118, Austin, TX 78757-8052 | 2005-12-07 |
| 1588198808 | Capitol Gastro, Pa | Internal Medicine | 12701 Rr 620 N Ste 101, Austin, TX 78750-1141 | 2017-04-13 |
| 1629498068 | Sanaa Somalya Arastu | Internal Medicine | 1111 W 34th St Ste 200, Austin, TX 78705-1916 | 2014-04-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.