DR. DIANE MARLENE ELLIS (NPI# 1770527426) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770527426 |
| Entity Type | Individual |
| Full Name | DR. DIANE MARLENE ELLIS |
| Other Name | MS. DIANE MARLENE BAILEY |
| Credential | PSY.D., LP |
| Practice Address |
323 E Grand St Springfield MO 65807-1447 |
| Mailing Address |
1300 E Bradford Pkwy Springfield MO 65804-4264 |
| Practice Telephone | 4177615600 |
| Mailing Telephone | 4177615000 |
| Mailing Fax Number | 4177615065 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2019-03-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2007033885 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 497428003 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1300 E Bradford Pkwy, Springfield, MO 658044264 | 4177615600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982091690 | Diane Carol Ellis | Social Worker | 5527 W Marconi Ave, Glendale, AZ 85306-2402 | 2015-04-20 |
| 1447448865 | Diane Elizabeth Ellis | Obstetrics & Gynecology | 461 S 400 E, Salt Lake City, UT 84111-3302 | 2007-10-10 |
| 1982756078 | Diane Lynn Ellis | Pharmacist | 8415 Bayshore Blvd, Tampa, FL 33621-1607 | 2007-01-17 |
| 1033147533 | Diane H. Ellis | Physical Therapist | 30 Peck Rd, Torrington, CT 06790-6123 | 2006-06-30 |
| 1609856277 | Diane S Ellis | Anesthesiology | 8000 E Maplewood Ave Ste 200, Greenwood Village, CO 80111-4727 | 2006-01-19 |
| Street Address |
323 E GRAND ST |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-1447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144202912 | Erika L Crabtree | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2005-11-17 |
| 1104427624 | Lee Owen Cunningham | Pharmacist | 323 E Grand St, Springfield, MO 65807-1447 | 2020-11-02 |
| 1922513894 | Micah A Gillen | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2017-12-13 |
| 1548612468 | Tedra E Estis | Nurse Practitioner | 323 E Grand St, Springfield, MO 65807-1447 | 2016-07-02 |
| 1194190066 | Burrell, Inc. | Pharmacy | 323 E Grand St, Springfield, MO 65807-1447 | 2015-12-03 |
| 1295113694 | Jeremy W Dickson | Counselor | 323 E Grand St, Springfield, MO 65807 | 2015-05-18 |
| 1396144051 | Tanya Rea Johnson | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2014-08-19 |
| 1730475666 | Susan Michelle Baker | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2011-06-20 |
| 1942523493 | Cristin R Martinez | Counselor | 323 E Grand St, Springfield, MO 65807-1447 | 2010-03-11 |
| 1093848913 | Advocates for A Healthy Community, Inc | Clinic/Center | 323 E Grand St, Springfield, MO 65807-1447 | 2007-03-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710509187 | Laura M Maggio | Psychologist | 11 Stephanie Cir, Springfield, MA 01129-1961 | 2020-05-08 |
| 1215556386 | Lotus Healing Center LLC | Psychologist | 28 Millburn Ave Ste 6, Springfield, NJ 07081-1023 | 2020-04-09 |
| 1194359216 | Kathrin A Koehler | Psychologist | 4674 Hominy Ridge Rd, Springfield, OH 45502-8031 | 2020-02-27 |
| 1689126120 | Assessment Consultants, LLC | Psychologist | 2146 W Chesterfield Blvd Ste E202, Springfield, MO 65807-8650 | 2016-11-01 |
| 1003366436 | Caitriona Hayes | Psychologist | 8134 Old Keene Mill Road, Suite 101, Springfield, VA 22152 | 2016-10-10 |
| 1669929907 | Richart Lipe Demier | Psychologist | 5871 S Northern Ridge Rd, Springfield, MO 65810-1976 | 2016-09-03 |
| 1043660905 | Safe Harbor Christian Counseling of Northern Virginia LLC | Psychologist | 8304 Old Keene Mill Rd, Springfield, VA 22152-1640 | 2016-06-21 |
| 1659786432 | Kimberly Wilkins Psyd LLC | Psychologist | 1344 W Oakville Rd, Springfield, MO 65810-1696 | 2014-06-30 |
| 1548507817 | Bahn and Associates | Psychologist | 3000 Professional Dr Ste D, Bahn Consulting, Inc., Springfield, IL 62703-5931 | 2013-01-07 |
| 1396004990 | Cultivate Psychological Services LLC | Psychologist | 1439 S Rogers Ave, Springfield, MO 65804-1129 | 2012-05-16 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
Please comment or provide details below to improve the information on DR. DIANE MARLENE 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.