MATTHEW NIGEL HUGH ELLIS (NPI# 1619504958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619504958 |
| Entity Type | Individual |
| Full Name | MATTHEW NIGEL HUGH ELLIS |
| Credential | MD |
| Practice Address |
4614 Country Club Rd Winston Salem NC 27104-3520 |
| Mailing Address |
2315 Duncan Dr Apt 8 Fairborn OH 45324-2079 |
| Practice Telephone | 3367162011 |
| Practice Fax Number | 3367165168 |
| Mailing Telephone | 8609830021 |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-03-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | NC | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740347871 | Matthew Ellis | Physical Therapist | 1250 Bergen Pkwy # E10, Evergreen, CO 80439-9584 | 2007-01-01 |
| 1871540716 | Matthew S Ellis | Emergency Medicine | 6400 W Newberry Rd Ste 104, Gainesville, FL 32605-4399 | 2006-05-27 |
| 1598739187 | Matthew Ellis | Chiropractor | 750 W Market St Ste 200, Lima, OH 45801-4602 | 2006-02-13 |
| 1184104143 | Matthew Ellis | Case Manager/Care Coordinator | 4464 S Dixie Hwy, Middletown, OH 45005-5464 | 2018-08-20 |
| 1639694672 | Matthew Ryan Ellis | Dentist | 140 Hidden Valley Pkwy, Norco, CA 92860-4000 | 2017-08-10 |
| 1720461593 | Matthew Jeremy Ellis | Pharmacist | 800 Rose St, Lexington, KY 40536-0001 | 2015-06-29 |
| 1366844219 | Matthew Ellis | Nurse Anesthetist, Certified Registered | 80 Seymour St, Hartford, CT 06106-3315 | 2014-09-23 |
| 1316048424 | Matthew J. Ellis | Internal Medicine | 40 Duke Medicine Cir, Durham, NC 27710-4000 | 2006-09-25 |
| 1669495685 | Matthew J Ellis | Internal Medicine | 6620 Main St, Suite 1350, Houston, TX 77030-2348 | 2006-07-25 |
| 1346237641 | Matthew L Ellis | Pharmacist | 1700 Cerrillos Rd, Santa Fe, NM 87505-3554 | 2005-10-02 |
| Street Address |
4614 COUNTRY CLUB RD |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27104-3520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306823547 | William Y Rice IIi | Internal Medicine | 4614 Country Club Rd, Winston Salem, NC 27104-3520 | 2005-12-29 |
| 1275162299 | Alexandria Jade Sutton | Student in an Organized Health Care Education/Training Program | 4614 Country Club Rd, Winston Salem, NC 27104-3520 | 2020-04-02 |
| 1609416932 | Emily Stefano | Psychologist | 4614 Country Club Rd, Winston Salem, NC 27104-3520 | 2020-01-15 |
| 1578113486 | Kayla Hansen | Dietitian, Registered | 4614 Country Club Rd, Winston Salem, NC 27104-3520 | 2019-09-13 |
| 1356867162 | Michelle Faulkner | Dietitian, Registered | 4614 Country Club Rd, Winston Salem, NC 27104-3520 | 2017-08-15 |
| 1245681097 | Jeanine Rivituso Kennedy | Dietitian, Registered | 4614 Country Club Rd, Winston Salem, NC 27104-3520 | 2016-06-23 |
| 1932532553 | Shenelle Alyse Edwards | Clinical Neuropsychologist | 4614 Country Club Rd, Winston Salem, NC 27104-3520 | 2013-08-19 |
| 1467885244 | Megan H. Ragone | Social Worker | 4614 Country Club Rd, Winston Salem, NC 27104-3520 | 2013-08-15 |
| 1669712840 | Terrika Dene Stewart Simmons | Nurse Practitioner | 4614 Country Club Rd, Winston Salem, NC 27104-3520 | 2013-02-25 |
| 1144480716 | Stephanie Jane Myers | Internal Medicine | 4614 Country Club Rd, Winston Salem, NC 27104-3520 | 2008-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447807664 | Cameron Grant Ford | Psychologist | 614 Country Club Road, Winston-salem, NC 27104 | 2019-08-22 |
| 1104310374 | Novant Medical Group, Inc. | Internal Medicine | 4937 Old Country Club Rd, Winston Salem, NC 27104 | 2018-06-20 |
| 1982100509 | Dillon James Magalski | Student in an Organized Health Care Education/Training Program | Piedmont Plaza 1, 1920 West First Street, Wake Forest Baptist Medical Center, Winston-salem, NC 27104 | 2018-04-03 |
| 1891290144 | Breann M Poling | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center, Department Of, Family Medicine Piedmont Plaza I 1920 West First Street, Winston Salem, NC 27104 | 2018-03-28 |
| 1689178600 | Christopher Vasil | Student in an Organized Health Care Education/Training Program | Piedmont Plaza I, 1920 West First Street, Department of Family Medicine, Winston Salem, NC 27104 | 2018-03-23 |
| 1407379126 | April Lynn Lowe | Registered Nurse | 940 N Peace Haven Rd, Winstonsalem, NC 27104 | 2017-07-25 |
| 1164950804 | Donald Joyce | Student in an Organized Health Care Education/Training Program | 1920 West First St, Piedmont Plaza I Building, 3rd Floor, Winston-salem, NC 27104 | 2017-05-25 |
| 1255867289 | Benjamin Hansen | Pharmacist | 2150 Country Club Rd Ste 300, Winston Salem, NC 27104 | 2017-05-11 |
| 1770020976 | Jane Reed | Physical Medicine & Rehabilitation | 2627 E Greenbrier Road, Winston Salem, NC 27104 | 2017-01-25 |
| 1053728261 | Ashraf Alsaedi | Pharmacist | 1659 Stratford Rd Nw, Winston Salem, NC 27104 | 2014-07-20 |
| Find all providers in zip 27104 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427659747 | Lakisha Henry-simmons | Student in an Organized Health Care Education/Training Program | 4298 Falcon Rd, Winston Salem, NC 27106-9425 | 2020-11-03 |
| 1366040503 | William Tommy Sparks | Student in an Organized Health Care Education/Training Program | 1012 S Hawthorne Rd, Winston Salem, NC 27103-4419 | 2020-10-10 |
| 1386258432 | Valerie Miller | Student in an Organized Health Care Education/Training Program | 601 Mlk Jr Dr, Winston Salem, NC 27110-0001 | 2020-09-05 |
| 1942814074 | Joyous Hawkins | Student in an Organized Health Care Education/Training Program | 601 S Martin Luther King, Winston Salem, NC 27110-0001 | 2020-09-05 |
| 1326652504 | Emily Claire Skoglund | Student in an Organized Health Care Education/Training Program | 601 S Martin Luther King Jr Dr Fl 432, Winston Salem, NC 27110-0001 | 2020-09-03 |
| 1750903233 | Rachel Elizabeth Crespi | Student in an Organized Health Care Education/Training Program | 3517 Summerfield Ln, Winston Salem, NC 27106-4295 | 2020-05-07 |
| 1023639325 | Christopher Gregg Marler Jr. | Student in an Organized Health Care Education/Training Program | 1 Medical Center Blvd Winston-salem N Surgery Clinic, Winston Salem, NC 27157-0001 | 2020-04-28 |
| 1912526005 | Hunter Bright Yancey | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center 1 Me, Winston Salem, NC 27157-0001 | 2020-04-09 |
| 1033748371 | Chukwuweike U Gwam | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Medical Center Medical Center Boul, Winston Salem, NC 27157-0001 | 2020-04-08 |
| 1386273175 | Mehrnoosh Ghandili | Student in an Organized Health Care Education/Training Program | Wake Forest Baptist Health One Medical Center Blvd, Winston Salem, NC 27157-0001 | 2020-04-03 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27104 |
Please comment or provide details below to improve the information on MATTHEW NIGEL HUGH ELLIS.
| 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.