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DR. JORDAN MICHAEL ELLIS PHD
NPI 1972167161
Psychologist - Clinical in Jb Andrews, MD

Active since April 24, 2019
1060 W PERIMETER RD, JB ANDREWS, MD 20762(240) 857-7186 Get Directions Write a Review

NPPES record last updated: June 16, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 16, 2025, Dec 1, 2020, Aug 13, 2020 and 1 more (4 updates tracked since 2019).

About Dr. Jordan Michael Ellis Phd NPPES

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

DR. JORDAN MICHAEL ELLIS PHD (NPI 1972167161) is an individual clinical provider in Jb Andrews, Maryland, licensed in Virginia (0810007310) and active in the NPI registry since April 2019.

NPPES Registry Identity

NPI1972167161
Entity TypeIndividualMale
Primary Taxonomy103TC0700X
Provider Legal NameDR. JORDAN MICHAEL ELLISCredential: PHD
Location Address1060 W PERIMETER RDJb Andrews, MD 20762-6602
Mailing Address1100 Wilford Hall Loop, Bldg. 4554, 59 Mdw/gme, Jbsa LacklandJbsa Lackland, TX 78236
Phone(240) 857-7186
Sole ProprietorNo
Enumeration DateApril 24, 2019
Last NPPES UpdateJune 16, 20254 updates tracked since enumeration
NPPES CertifiedJune 16, 2025
✔ NPI 1972167161 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code103TC0700X
License✔ Licensed in VA · 0810007310
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
Also ListedPsychologist · HealthTaxonomy 103TH0004X
1060 W PERIMETER RD, Jb Andrews, MD 20762
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Other Providers at the Same Location NPPES 20

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

CHELSEA BIANCA PAYNE M.D.
Family Medicine
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (907) 377-6722
MS. PATRICIA BANASZEK HAZARD CRNP
Nurse Practitioner (Obstetrics & Gynecology)
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (240) 612-1400
MR. KOMI VENUNYE GAYAKPA IDC
Military Health Care Provider (Independent Duty Corpsman)
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (651) 354-8825
AMANDA MARIE HAWKINS MD
Obstetrics & Gynecology
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (240) 612-1400
DR. JULIE ANN BANTA PT, DPT, FAAOMPT
Physical Therapist
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (240) 612-2464
DR. SUBODH ARORA MD
Pediatrics
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (301) 404-9046
MR. JEREMY TROY POWELL PA-C
Physician Assistant
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (240) 612-1143
CASSANDRA VERHOFF MS, RD, LDN
Dietitian, Registered
1060 W PERIMETER RD
JB ANDREWS, MD 20762
Prince George's County (240) 612-2678

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 Jordan Ellis's NPI number?

The NPI number for Jordan Ellis is 1972167161. It was assigned to this individual provider in the NPPES registry on April 24, 2019.

Where is Jordan Ellis located?

Jordan Ellis practices at 1060 W Perimeter Rd, Jb Andrews, MD 20762. The listed phone number is (240) 857-7186.

What is Jordan Ellis's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Jordan Ellis was last updated on June 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.