ETHAN R ELLIS (NPI# 1316110208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316110208 |
| Entity Type | Individual |
| Full Name | ETHAN R ELLIS |
| Credential | M.D. |
| Practice Address |
2121 E Harmony Rd Ste 100 Fort Collins CO 80528-3400 |
| Practice Telephone | 9702211000 |
| Mailing Telephone | 9702211000 |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2016-03-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | DR.0053902 | CO | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 235720 | MA | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
DR.0053902 | CO | Allopathic & Osteopathic Physicians |
| Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
DR.0053902 | CO | Allopathic & Osteopathic Physicians |
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
27958 | NE | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 87529351 | 05 |
| Street Address |
2121 E HARMONY RD STE 100 |
| City | FORT COLLINS |
| State | CO |
| Zip Code | 80528-3400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295737526 | Carrie Lynn Campbell Broughton | Internal Medicine | 2121 E Harmony Rd, Suite 310, Fort Collins, CO 80528-3400 | 2005-05-31 |
| 1851916407 | Jonathan Klassen | Genetic Counselor, MS | 2121 E Harmony Rd, Fort Collins, CO 80528-3400 | 2020-06-10 |
| 1508374364 | Jennifer Mommer | Nurse Practitioner | 2121 E Harmony Rd, Suite 100, Fort Collins, CO 80528-3401 | 2018-01-15 |
| 1043744543 | Seth Holland | Pharmacist | 2121 E Harmony Rd, Fort Collins, CO 80528-3400 | 2017-04-12 |
| 1396279832 | Carrie Allen | Pharmacist | 2121 E Harmony Rd, Suite 170, Fort Collins, CO 80528-3400 | 2017-04-11 |
| 1609317890 | Tomi Folkestad | Pharmacist | 2121 E Harmony Rd, Suite 170, Fort Collins, CO 80528-3400 | 2017-03-20 |
| 1295285377 | Lindsay Sinclair | Pharmacist | 2121 E Harmony Rd, Suite 170 (pharmacy), Fort Collins, CO 80528-3400 | 2016-10-12 |
| 1851841753 | Associates In Family Medicine, P.C. | Family Medicine | 2121 E Harmony Rd, Suite 370, Fort Collins, CO 80528-3400 | 2016-10-04 |
| 1639541550 | Jaime Cazer | Registered Nurse | 2121 E Harmony Rd, Suite 100, Fort Collins, CO 80528-3400 | 2015-10-30 |
| 1699146183 | Lindsay Bennett | Nurse Practitioner | 2121 E Harmony Rd, Suite 310, Fort Collins, CO 80528-3400 | 2015-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518475391 | Corinna Kromer | Specialist | 4818 Snowdrift Circle, Fort Collins, CO 80528 | 2018-01-16 |
| 1447793419 | Suites Fort Collins LLC | Skilled Nursing Facility | 4880 Ziegler Rd, Fort Collins, CO 80528 | 2016-11-23 |
| 1790231413 | Pineridge Healthcare, Inc. | Skilled Nursing Facility | 4880 Ziegler Road, Fort Collins, CO 80528 | 2016-09-01 |
| 1750647244 | Annika Svea Kamberelis | Physician Assistant | 2121 E Harmony Rd Unit 300, Fort Collins, CO 80528 | 2012-04-09 |
| 1831481944 | Natasha E. Walter-fisk | Counselor | 5225 White Willow Dr. M220, Fort Collins, CO 80528 | 2011-05-07 |
| 1629216627 | Augusto Miravalle | Psychiatry & Neurology | 2121 E. Harmony Road, Suite 180, Ft Collins, CO 80528 | 2009-01-29 |
| 1114100252 | Alicia R. Young | Psychologist | 8010 S Country Road 5, Suite 201, Windsor, CO 80528 | 2007-12-12 |
| 1346446903 | Jill Marie Olson | Psychiatry & Neurology | 2121 E. Harmony Road #180, Fort Collins, CO 80528 | 2007-06-21 |
| 1437368578 | Shelley M Oliver | Orthopaedic Surgery | 2121 E. Harmony Rd. Ste 290, Fort Collins, CO 80528 | 2007-05-22 |
| 1174748008 | Light of The Rockies Christian Counseling Center | Clinic/Center | 5236 Strauss Cabin Rd, Fort Collins, CO 80528 | 2007-04-16 |
| Find all providers in zip 80528 | ||||
| Taxonomy Code | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
| 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 |
|---|---|---|---|---|
| 1306163621 | Poudre Valley Medical Group, LLC | Internal Medicine | 2121 E Harmony Rd Unit 100, Fort Collins, CO 80528-3401 | 2010-04-26 |
| 1649276536 | Heart & Vascular Clinic of Northern Colorado, P.C. | Internal Medicine | 2121 E Harmony Rd, Unit 200, Fort Collins, CO 80528-3401 | 2005-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669936936 | Vladimir N Kolomyza | Internal Medicine | 12685 Bellaire St, Thornton, CO 80241-2903 | 2019-01-30 |
| 1013227651 | Colorado Heart and Vascular PC | Internal Medicine | 11700 W 2nd Place, Suite 350, Lakewood, CO 80228-1710 | 2010-10-18 |
| 1790914661 | Amneet Sandhu | Internal Medicine | 1700 Wheeling St # F2-171, Aurora, CO 80045-7211 | 2009-07-13 |
| 1366406936 | Electrophysiology Associates, P.C. | Internal Medicine | 215 Parkside Dr, Suite 100, Colorado Springs, CO 80910-3131 | 2006-04-12 |
| 1144862327 | Parkview Ancillary Services | Internal Medicine | 1600 N. Grand Ave., Ste. 500b, Pueblo, CO 81003-2757 | 2019-10-09 |
| 1528477262 | Syed Rafay Ali Sabzwari | Internal Medicine | 12605 E 16th Ave, Aurora, CO 80045-2545 | 2014-08-06 |
| 1023332517 | Jason Huang | Internal Medicine | 4545 E 9th Ave Ste 670, Denver, CO 80220-3918 | 2010-03-26 |
| 1588806483 | Ryan T Borne | Internal Medicine | 12605 E. 16th Avenue, University of Colorado Hospital, Aurora, CO 80045 | 2009-03-24 |
| 1881849941 | T Duncan Sellers, Electrophysiologist | Internal Medicine | 525 N Foote Ave, Colorado Springs, CO 80909-4554 | 2008-11-17 |
| 1427201938 | Layth Saleh | Internal Medicine | 11700 W 2nd Pl Ste 350, Lakewood, CO 80228-1710 | 2008-10-28 |
| Find all providers with the same taxonomy | ||||
| City | FORT COLLINS |
| Zip Code | 80528 |
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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.