ELLIS MEDICAL CLINIC LLC
NPI 1871064568
Family Medicine in Ellis, KS

Active since December 06, 2018CLIA 17D2162299 · Waiver
814 JEFFERSON ST, ELLIS, KS 67637(785) 520-5020(785) 520-5025 Get Directions Write a Review

NPPES record last updated: February 16, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 16, 2019, Dec 6, 2018 (2 updates tracked since 2018).

About Ellis Medical Clinic Llc NPPES

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

ELLIS MEDICAL CLINIC LLC (NPI 1871064568) is a healthcare organization registered as a family medicine in Ellis, Kansas and active in the NPI registry since December 2018. The organization holds a CLIA Waiver certificate valid through February 19, 2027 and lists Christy Dawn Cunningham, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1871064568
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameELLIS MEDICAL CLINIC LLC
Location Address814 JEFFERSON STEllis, KS 67637-2215
Mailing AddressPo Box 174Ellis, KS 67637-0174 · (785) 259-4261 · Fax (785) 520-5025
Fax(785) 520-5025
Organization SubpartNo
Authorized OfficialChristy Dawn CunninghamBusiness Manager · (785) 520-5020
Enumeration DateDecember 6, 2018
Last NPPES UpdateFebruary 16, 20192 updates tracked since enumeration
NPI 1871064568 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

814 JEFFERSON ST, Ellis, KS 67637

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

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 17D2162299

Ellis Medical Clinic LLC · Ellis, KS
Active · expires Feb 19, 2027
CLIA Number17D2162299
Laboratory TypePhysician Office
Certificate Effective DateFebruary 20, 2025
Certificate Expiration DateFebruary 19, 2027
Laboratory DirectorHarley E. Calvin
Laboratory Phone(785) 520-5020
Laboratory LocationEllis Medical Clinic LLC814 Jefferson, Ellis, KS 67637
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.

Dentist (General Practice)
814 JEFFERSON ST
ELLIS, KS 67637

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 Medical Clinic LLC's NPI number?

The NPI number for Ellis Medical Clinic LLC is 1871064568. It was assigned to this organization in the NPPES registry on December 6, 2018.

Where is Ellis Medical Clinic LLC located?

Ellis Medical Clinic LLC is located at 814 Jefferson St, Ellis, KS 67637. The listed phone number is (785) 520-5020.

What is Ellis Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Ellis Medical Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 17D2162299) is associated with this NPI, valid through February 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ellis Medical Clinic LLC accept?

Health plans from Blue Cross and Blue Shield of Kansas, Inc. list Ellis Medical Clinic LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ellis Medical Clinic LLC was last updated on February 16, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.