GERALD ELLIS (NPI# 1487066676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487066676 |
Entity Type | Individual |
Full Name | GERALD ELLIS |
Other Name | GERALD ELLIS |
Practice Address |
10301 E State Road 37 Fort Wayne IN 46835-9591 |
Mailing Address |
6206 Twisted Oak Ct Fort Wayne IN 46835-2649 |
Practice Telephone | 2604921333 |
Mailing Telephone | 2604025429 |
Enumeration Date | 2014-05-22 |
Last Update Date | 2014-05-22 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1835P1200X |
Pharmacist Specialization: Pharmacotherapy |
26023966A | IN | Pharmacy Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245377134 | Gerald Ellis | Pharmacist | 676 University Blvd S, Mobile, AL 36609-7866 | 2007-01-31 |
1528144425 | Gerald Richard Ellis | Licensed Psychiatric Technician | 12440 Imperial Hwy, 116, Norwalk, CA 90650-3177 | 2006-10-31 |
Street Address |
10301 E STATE ROAD 37 |
City | FORT WAYNE |
State | IN |
Zip Code | 46835-9591 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174893978 | Meijer Stores Limited Partnership | Durable Medical Equipment & Medical Supplies | 10301 E State Road 37, Fort Wayne, IN 46835-9591 | 2012-01-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760993810 | Longe Enterprises Corp | Eyewear Supplier (Equipment, not the service) | 5711 Ymca Park Dr East, Fort Wayne, IN 46835 | 2017-10-17 |
1801144464 | Tracey Gordon | Physical Therapy Assistant | 2827 Northgate Boulevard, Fort Wayne, IN 46835 | 2012-08-29 |
1316179682 | Janet L Daniel | Counselor | 310 E Dupont Road, Suite 2, Fort Wayne, IN 46835 | 2009-08-20 |
1083868863 | Nicholas Joseph Sullivan | Chiropractor | 8320 Chapel Bend Drive, Fort Wayne, IN 46835 | 2008-11-06 |
1497922090 | Michelle A Bailey | Registered Nurse | 6108 Maplecrest Road, Fort Wayne, IN 46835 | 2008-05-13 |
1073789954 | Charles Arthur Bolinger | Technician, Other | 4546 Maplecrest Rd, Ft Wayne, IN 46835 | 2008-05-01 |
1851469878 | Richard J Klaehn | Optometrist | 4536 Maplecrest Road, Ft. Wayne, IN 46835 | 2006-11-30 |
1639272339 | Hook Superx LLC | Durable Medical Equipment & Medical Supplies | 6220 St Joseph Center Rd, Fort Wayne, IN 46835 | 2006-09-07 |
1275649014 | Adrienne Meyer | Pharmacist | 7909 Brixham Place, Fort Wayne, IN 46835 | 2006-08-22 |
1750378147 | The Health and Hospital Corporation of Marion County | Skilled Nursing Facility | 4430 Elsdale Dr, Fort Wayne, IN 46835 | 2005-09-30 |
Find all providers in zip 46835 |
Taxonomy Code | 1835P1200X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
Specialization | Pharmacotherapy |
A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy. |
Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033259197 | V E Butler and Associates PC | Pharmacist | 2700 S. Lafayette St, Communitycare Pharmacy, Fort Wayne, IN 46806-1100 | 2007-02-07 |
1669951877 | Kristen Elizabeth Christman | Pharmacist | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2018-08-08 |
1255820163 | Timothy Lee Johnston | Pharmacist | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2018-05-07 |
1134618150 | Elizabeth Meisberger | Pharmacist | 11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701 | 2018-05-04 |
1649702176 | Chris Johnson | Pharmacist | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2017-04-03 |
1619359981 | Andrew Jason Bergman | Pharmacist | 6309 Lima Rd, Fort Wayne, IN 46818-1425 | 2015-06-23 |
1003228974 | Margaret Mcdonald | Pharmacist | 5909 Illinois Rd, Fort Wayne, IN 46804-1159 | 2014-05-27 |
1588076863 | Ryan Ades | Pharmacist | 6309 Lima Rd, Fort Wayne, IN 46818-1425 | 2014-05-21 |
1619389095 | John Phillip Purvis | Pharmacist | 6309 Lima Rd, Fort Wayne, IN 46818-1425 | 2014-05-20 |
1033521497 | Steve Rigdon | Pharmacist | 10301 Maysville Rd, Fort Wayne, IN 46835-9591 | 2014-05-20 |
Find all providers in FORT WAYNE |
City | FORT WAYNE |
Zip Code | 46835 |
Please comment or provide details below to improve the information on GERALD ELLIS.
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.