ELAINE ELLIS CENTER OF HEALTH
NPI 1184164014
Clinic/Center - Federally Qualified Health Center (FQHC) in College Park, MD

Q: What is Elaine Ellis Center Of Health's NPI number?

The NPI number for Elaine Ellis Center Of Health is 1184164014. It was assigned to this organization in the NPPES registry on February 25, 2017.

Q: What is Elaine Ellis Center Of Health's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since February 25, 2017CLIA 21D2157128 · Waiver

10001 RHODE ISLAND AVE, COLLEGE PARK, MD 20740(301) 441-1605(301) 345-1609 Get Directions Write a Review

NPPES record last updated: March 1, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 1, 2017, Feb 25, 2017 (2 updates tracked since 2017).

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About Elaine Ellis Center Of Health NPPES

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

ELAINE ELLIS CENTER OF HEALTH (NPI 1184164014) is a healthcare organization registered as a federally qualified health center (fqhc) in College Park, Maryland and active in the NPI registry since February 2017. The organization holds a CLIA Waiver certificate valid through October 30, 2026 and lists Jacquelyn R Walker, Ceo, as its authorized official.

NPPES Registry Identity

NPI1184164014

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameELAINE ELLIS CENTER OF HEALTH

Location Address10001 RHODE ISLAND AVECollege Park, MD 20740-1141

Mailing Address10001 Rhode Island AveCollege Park, MD 20740-1141 · (301) 441-1605 · Fax (301) 345-1609

Phone(301) 441-1605

Fax(301) 345-1609

Organization SubpartNo

Authorized OfficialJacquelyn R WalkerCeo · (301) 441-1605

Enumeration DateFebruary 25, 2017

Last NPPES UpdateMarch 1, 20172 updates tracked since enumeration

✔ NPI 1184164014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

License✔ Licensed in DC · 400312000595

Also ListedClinic/Center · DentalTaxonomy 261QD0000X

Also ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X

10001 RHODE ISLAND AVE, College Park, MD 20740

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Other Identifiers 3

Medicaid500072600MD

Medicaid082390200DC

Medicare PIN091844

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2157128

Elaine Ellis Center Of Health · College Park, MD

Active · expires Oct 30, 2026

CLIA Number21D2157128

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateOctober 31, 2024

Certificate Expiration DateOctober 30, 2026

Laboratory DirectorGwendolyn L. Dunmore MD

Laboratory Phone(301) 441-1605

Laboratory LocationElaine Ellis Center Of Health10001 Rhode Island Avenue, College Park, MD 20740

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

ELAINE ELLIS CENTER OF HEALTH, INC.

Clinic/Center (Federally Qualified Health Center (FQHC))

10001 RHODE ISLAND AVE
COLLEGE PARK, MD 20740

Prince George's County (301) 441-1605

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 Elaine Ellis Center Of Health's NPI number?

The NPI number for Elaine Ellis Center Of Health is 1184164014. It was assigned to this organization in the NPPES registry on February 25, 2017.

Where is Elaine Ellis Center Of Health located?

Elaine Ellis Center Of Health is located at 10001 Rhode Island Ave, College Park, MD 20740. The listed phone number is (301) 441-1605.

What is Elaine Ellis Center Of Health's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Elaine Ellis Center Of Health hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2157128) is associated with this NPI, valid through October 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Elaine Ellis Center Of Health was last updated on March 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.