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DR. ELLIS KNOX LIST D.D.S.
NPI 1114921764
Dentist - General Practice in Durham, NC

Active since June 10, 2005Opted out of Medicare · through Apr 13, 2028
1014 LAMOND AVE, DURHAM, NC 27701(919) 682-5327(919) 688-4588 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Ellis Knox List D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. ELLIS KNOX LIST D.D.S. (NPI 1114921764) is an individual general practice provider in Durham, North Carolina, licensed in North Carolina (5687) and active in the NPI registry since June 2005. He has opted out of Medicare through April 13, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1114921764
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. ELLIS KNOX LISTCredential: D.D.S.
Location Address1014 LAMOND AVEDurham, NC 27701-2021
Mailing Address1014 Lamond AveDurham, NC 27701-2021 · (919) 682-5327 · Fax (919) 688-4588
Phone(919) 682-5327
Fax(919) 688-4588
Sole ProprietorNo
Enumeration DateJune 10, 2005
Last NPPES UpdateJuly 8, 2007
✔ NPI 1114921764 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in NC · 5687✔ Licensed in OH · 30-01-8657
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1014 LAMOND AVE, Durham, NC 27701
Open in Google Maps ↗

Other Identifiers 2

Other27028-1NC · Blue Cross/blue Shield #
Medicare UPINU41482NC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Ellis Knox List D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 13, 2016 through April 13, 2028.

Opt-Out Effective DateApril 13, 2016
Opt-Out In Effect ThroughApril 13, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27701 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LIFETIME CHIROPRACTIC PLLC
Chiropractor
1014 LAMOND AVE
DURHAM, NC 27701
Durham County (919) 797-0428
ELLIS K. LIST, D.D.S., P.A.
Dentist (General Practice)
1014 LAMOND AVE
DURHAM, NC 27701
Durham County (919) 682-5327

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ellis List's NPI number?

The NPI number for Ellis List is 1114921764. It was assigned to this individual provider in the NPPES registry on June 10, 2005.

Where is Ellis List located?

Ellis List practices at 1014 Lamond Ave, Durham, NC 27701. The listed phone number is (919) 682-5327.

What is Ellis List's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Ellis List enrolled in Medicare?

No. Ellis List has opted out of Medicare through April 13, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Ellis List was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.