DR. KEITH W. ELLIS (NPI# 1033275896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033275896 |
| Entity Type | Individual |
| Full Name | DR. KEITH W. ELLIS |
| Credential | MD |
| Practice Address |
2115 S Fremont Ave Suite 2300 Springfield MO 65804-2239 |
| Mailing Address |
Po Box 2580 Springfield MO 65801-2580 |
| Practice Telephone | 4178205600 |
| Practice Fax Number | 4178205606 |
| Mailing Telephone | 4178294620 |
| Mailing Fax Number | 4178294316 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2008-07-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 2000151548 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 204963003 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407849441 | Keith L Ellis | Marriage & Family Therapist | 557 Glover Ave, Suite 3, Enterprise, AL 36330-2024 | 2005-08-24 |
| 1144654666 | Keith Lawrence Ellis | Nurse Practitioner | 46 Albion St, Bridgeport, CT 06605-2602 | 2013-09-03 |
| 1194166942 | Keith Ellis | Counselor | 11 Ward St, Somerville, MA 02143-4214 | 2013-07-09 |
| 1972823367 | Keith Ellis | Physical Therapist | 751 E Porter Ave Ste 2, Chesterton, IN 46304-9111 | 2010-06-08 |
| 1356490775 | Keith Errett Ellis | Family Medicine | 1107 E 66th St, Savannah, GA 31404-5701 | 2007-01-09 |
| Street Address |
2115 S FREMONT AVE SUITE 2300 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-2239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750383543 | Steven K Bowlin | Internal Medicine | 2115 S Fremont Ave, Ste 2300, Springfield, MO 65804-2239 | 2005-08-11 |
| 1932656535 | Jill Cotner | Registered Nurse | 2115 S Fremont Ave, Ste 3300, Springfield, MO 65804-2239 | 2016-09-01 |
| 1427437185 | Ashleigh D. Gentles | Nurse Practitioner | 2115 S Fremont Ave, Springfield, MO 65804-2239 | 2015-05-27 |
| 1063805489 | Chad D. Holland | Physician Assistant | 2115 S Fremont Ave, Suite 5000, Springfield, MO 65804-2239 | 2015-03-10 |
| 1609267731 | Chrystal M. Killinger | Nurse Practitioner | 2115 S Fremont Ave, Suite 3300, Springfield, MO 65804-2239 | 2015-02-11 |
| 1497145767 | Joshua Steven Reece | Physician Assistant | 2115 S Fremont Ave, Ste 5000, Springfield, MO 65804-2239 | 2015-01-26 |
| 1154724144 | Melissa Diane Grisaffe | Nurse Practitioner | 2115 S Fremont Ave, Springfield, MO 65804-2239 | 2014-10-03 |
| 1790102366 | Breanna R. Burks | Physician Assistant | 2115 S Fremont Ave, Ste 4300, Springfield, MO 65804-2239 | 2014-03-21 |
| 1154745537 | Tarrah Divine | Nurse Practitioner | 2115 S Fremont Ave, Ste 4300, Springfield, MO 65804-2239 | 2014-02-06 |
| 1831539428 | Lacy A. Schnelle | Registered Nurse | 2115 S Fremont Ave, Suite 4300, Springfield, MO 65804-2239 | 2013-06-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639675077 | Anand Kanjolia, M.d. LLC | Internal Medicine | 222 Carew St Fl 4, Springfield, MA 01104-4109 | 2018-04-04 |
| 1376068817 | Personal Primary Care and Weight Management, LLC | Internal Medicine | 299 Carew St Ste 234, Springfield, MA 01104-2368 | 2017-08-05 |
| 1184145682 | Basma Al-bast | Internal Medicine | 701 N 1st St Ste 434, Springfield, IL 62702-3757 | 2017-07-05 |
| 1689124604 | John Duff | Internal Medicine | 2909 S Camber Ave, Springfield, MO 65809-3547 | 2016-10-13 |
| 1669834941 | Siddhi Joshi | Internal Medicine | 5501 Backlick Rd Ste 105, Springfield, VA 22151-3940 | 2016-03-24 |
| 1265898936 | Mohammad Rahimuddin | Internal Medicine | 2556 Snyder Domer Rd, Springfield, OH 45502-8161 | 2016-01-11 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1033589304 | Hshs Medical Group Inc | Internal Medicine | 3215 Executive Park Dr, Springfield, IL 62703-4514 | 2015-09-30 |
| 1679992895 | Ahlam Elbadri | Internal Medicine | 2115 S Fremont Ave Ste 2300, Springfield, MO 65804-2233 | 2014-04-15 |
| 1528487543 | Barbara Vinci | Internal Medicine | 2443 Troy Rd, Springfield, OH 45504-4233 | 2014-04-08 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.