DR. TIMOTHY J. ELLIS (NPI# 1285644856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285644856 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY J. ELLIS |
| Credential | O.D. |
| Practice Address |
500 W Fort St Boise ID 83702-4501 |
| Mailing Address |
2827 Heather Pl Boise ID 83702-1428 |
| Practice Telephone | 2084221000 |
| Practice Fax Number | 2084221080 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 0882 | ID | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588767040 | Timothy Mark Ellis | Dentist | 2110 E Flamingo Dr, Bartow, FL 33830-4236 | 2006-09-07 |
| 1124013008 | Timothy Edward Ellis | Physical Therapist | 319a Julian Ave, Healthcare Consultants Inc, Thomasville, NC 27360-4832 | 2005-09-15 |
| 1114388303 | Timothy Ellis | Specialist/Technologist | 1200 Providence Rd, Wayne, NE 68787-1212 | 2016-03-15 |
| 1669801866 | Timothy Allan Ellis | Physician Assistant | 300 W Central Texas Expy Ste 115, Harker Heights, TX 76548-1888 | 2013-11-07 |
| 1801143813 | Timothy Ray Ellis | Dentist | 11836 Elm St, Suite 1, Omaha, NE 68144-4438 | 2012-08-08 |
| 1790040863 | Timothy Michael Ellis | Pharmacist | 7611 Pineville Matthews Rd, Charlotte, NC 28226-3909 | 2012-07-05 |
| Street Address |
500 W FORT ST |
| City | BOISE |
| State | ID |
| Zip Code | 83702-4501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063411007 | Sandra Gee Jue | Pharmacist | 500 W Fort St, Bldg 44a, Boise, ID 83702-4501 | 2005-07-20 |
| 1952902389 | Christine Alice Walsh | Recreation Therapist | 500 W Fort St, Boise, ID 83702-4501 | 2020-11-03 |
| 1386243160 | Elizabeth Larsen | Registered Nurse | 500 W Fort St, Boise, ID 83702-4598 | 2020-10-22 |
| 1013516293 | Rebecca Cotterell | Registered Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-10-20 |
| 1487253670 | Morgan Wussow | Registered Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-10-20 |
| 1548867435 | Justin Hyer | Registered Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-10-05 |
| 1881209336 | Daniel James Councell | Physician Assistant | 500 W Fort St, Boise, ID 83702-4501 | 2020-09-11 |
| 1508470451 | Marcus J Day | Registered Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-09-08 |
| 1386258291 | Vanessa Potoski | Registered Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-09-08 |
| 1033723788 | Brian Lynn Lambrecht | Licensed Practical Nurse | 500 W Fort St, Boise, ID 83702-4501 | 2020-09-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536362 | Daniel & Max, LLC | Optometrist | 1405 N Milwaukee St, Boise, ID 83704-8400 | 2020-10-20 |
| 1326669920 | Clear Eyes Optometric Care, Pllc | Optometrist | 7950 Horseshoe Bend Rd Ste 101, Boise, ID 83714-3809 | 2020-05-05 |
| 1326550096 | Lawrence D Anderson Md Estate | Optometrist | 8955 W Hackamore Dr, Boise, ID 83709 | 2017-11-02 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1811388796 | Barber Town Eye Care | Optometrist | 3132 S Bown Way, Boise, ID 83706-5400 | 2015-02-12 |
| 1255742532 | Tiffany Risner | Optometrist | 610 S Americana Blvd, Boise, ID 83702-6731 | 2014-05-08 |
| 1154690923 | Gem State Family Eyecare, P.C. | Optometrist | 3815 W State St, Boise, ID 83703-5221 | 2011-12-22 |
| 1750678298 | Wendell Fackrell | Optometrist | 421 N. Cole Rd. Ste 102, Boise, ID 83704 | 2011-07-05 |
| 1972813855 | Dylan L Hatfield | Optometrist | 360 E. Mallard Dr. Ste 110, Hollingshead Eye Center, Boise, ID 83706-3945 | 2010-10-13 |
| 1043521941 | Nessa Livingston | Optometrist | 7960 W Rifleman St Ste 150, Boise, ID 83704-9065 | 2010-06-24 |
| Find all providers in BOISE | ||||
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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.