NOLAN ANDREW ELLIS DIVE IDC
NPI 1174019046
Military Health Care Provider - Independent Duty Corpsman in San Diego, CA

Q: What is Nolan Ellis's NPI number?

The NPI number for Nolan Ellis is 1174019046. It was assigned to this individual provider in the NPPES registry on July 3, 2018.

Q: What is Nolan Ellis's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Nolan Ellis was last updated on July 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.

Active since July 03, 2018

3156 SALMON ST, SAN DIEGO, CA 92124(859) 802-9800 Get Directions Write a Review

NPPES record last updated: July 3, 2018. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Nolan Andrew Ellis Dive Idc NPPES

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

NOLAN ANDREW ELLIS DIVE IDC (NPI 1174019046) is an individual independent duty corpsman provider in San Diego, California and active in the NPI registry since July 2018.

NPPES Registry Identity

NPI1174019046

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameNOLAN ANDREW ELLISCredential: DIVE IDC

Location Address3156 SALMON STSan Diego, CA 92124-3616

Mailing Address3156 Salmon StSan Diego, CA 92124-3616

Phone(859) 802-9800

Sole ProprietorYes

Enumeration DateJuly 3, 2018

✔ NPI 1174019046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

3156 SALMON ST, San Diego, CA 92124

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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 Nolan Ellis's NPI number?

The NPI number for Nolan Ellis is 1174019046. It was assigned to this individual provider in the NPPES registry on July 3, 2018.

Where is Nolan Ellis located?

Nolan Ellis practices at 3156 Salmon St, San Diego, CA 92124. The listed phone number is (859) 802-9800.

What is Nolan Ellis's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Nolan Ellis was last updated on July 3, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.