ELLIS MEDICAL CLINIC LLC
NPI 1871064568
Family Medicine in Ellis, KS
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
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Ellis Medical Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Ellis Medical Clinic LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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, KSFrequently 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.
Is Ellis Medical Clinic LLC enrolled in Medicare?
Yes. Ellis Medical Clinic LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Ellis Medical Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Ellis Medical Clinic LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.
# Ellis Medical Clinic Llc · NPI 1871064568
Family Medicine organization in Ellis, Kansas. Organization record, active in the CMS NPPES registry since December 6, 2018.
## Identity
- **NPI:** 1871064568 (Entity type: Organization)
- **Enumerated:** December 6, 2018
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Christy Cunningham, BUSINESS MANAGER
## Practice location
- **Address:** 814 JEFFERSON ST, Ellis, KS 67637-2215
- **Phone:** (785) 520-5020 · **Fax:** (785) 520-5025
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 16, 2019
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1871064568) · Data from the CMS NPPES public registry.