DR MARK F ELLIS DPMA PROFESSIONAL MEDICAL CORPORATION (NPI# 1811934268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811934268 |
| Entity Type | Organization |
| Organization Name | DR MARK F ELLIS DPMA PROFESSIONAL MEDICAL CORPORATION |
| Practice Address |
501 W Saint Mary Blvd Ste 520 Lafayette LA 70506-4600 |
| Practice Telephone | 3375931278 |
| Practice Fax Number | 3375931280 |
| Mailing Telephone | 3375931278 |
| Mailing Fax Number | 3375931280 |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2008-06-16 |
| Authorized Official Name | MARK ELLIS (PHYSICIAN) |
| Authorized Official Telephone | 3375931278 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
1670511 | LA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1670511 | 05 |
| Street Address |
501 W SAINT MARY BLVD STE 520 |
| City | LAFAYETTE |
| State | LA |
| Zip Code | 70506-4600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194729657 | Amelie Anne Hollier | Nurse Practitioner | 501 W Saint Mary Blvd, Ste 416, Lafayette, LA 70506-4600 | 2005-06-10 |
| 1669859278 | Franciscan Pace | Clinic/Center | 501 W Saint Mary Blvd, Suite 200, Lafayette, LA 70506-4600 | 2015-05-04 |
| 1366858904 | Samantha Nicole Ashcraft | Physician Assistant | 501 W Saint Mary Blvd, Suite 110, Lafayette, LA 70506-4600 | 2014-07-03 |
| 1316294671 | Anna Katharine Prejean | Nurse Practitioner | 501 W Saint Mary Blvd, Suite 320, Lafayette, LA 70506-4600 | 2012-08-06 |
| 1134443138 | Troy D Guidry | Family Medicine | 501 W Saint Mary Blvd, Ste 320, Lafayette, LA 70506-4600 | 2010-03-19 |
| 1821323361 | Farhana Amir, Md | Internal Medicine | 501 W Saint Mary Blvd, Suite 320, Lafayette, LA 70506-4600 | 2009-10-15 |
| 1730310392 | Stephen R Simpson Md LLC | Internal Medicine | 501 W Saint Mary Blvd, Ste 220, Lafayette, LA 70506-4600 | 2009-07-30 |
| 1982834966 | Spine Institute of Southwest Louisiana, LLC | Pain Medicine | 501 W Saint Mary Blvd, Suite 416, Lafayette, LA 70506-4600 | 2009-07-23 |
| 1710154323 | Lourdes Imaging Center LLC | Radiology | 501 W Saint Mary Blvd, Suite 108, Lafayette, LA 70506-4600 | 2008-05-13 |
| 1972775005 | Cindy K Stelly | Nurse Practitioner | 501 W Saint Mary Blvd, Suite 200, Lafayette, LA 70506-4600 | 2008-03-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417421447 | Maranda Washington | Student in an Organized Health Care Education/Training Program | 202 Reinhardt Drive, Lafayette, LA 70506 | 2019-01-12 |
| 1447742473 | Glenda Gravouilla Poulan | Driver | 330 Guilbeau Rd, Lafayette, LA 70506 | 2018-06-05 |
| 1194215905 | Angelica Plumbar | Case Manager/Care Coordinator | 1304 Bertrand Dr Ste B21304, Lafayette, LA 70506 | 2018-05-16 |
| 1801394820 | Acadiana Ambulatory Health Care Services | Non-Pharmacy Dispensing Site | 207 Westmark Blvd., Lafayette, LA 70506 | 2018-01-24 |
| 1578070041 | Kimberly Lois Robinson | Counselor | 203 Pinto St, Lafayette, LA 70506 | 2018-01-05 |
| 1558890814 | Shanece Marie Solomon | Speech-Language Pathologist | 326 Guilbeau Rd Apt 240, Lafayette, LA 70506 | 2017-06-08 |
| 1225565625 | Keena Lewis | Case Manager/Care Coordinator | 121 Kohen Luke Dr, Lafayette, LA 70506 | 2017-05-16 |
| 1326571498 | Natasha Deville | Community/Behavioral Health | 1408 W Willow St 162, Lafayette, LA 70506 | 2017-04-06 |
| 1952846826 | Mia D Arthur | Behavioral Analyst | 511 Monarch Dr, Lafayette, LA 70506 | 2016-12-30 |
| 1265983340 | Eric Prince | Specialist/Technologist | 202 Reinhardt Dr., Lafayette, LA 70506 | 2016-10-24 |
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| Taxonomy Code | 213ES0131X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770699522 | Gregory A Schweikher | Podiatrist | 2020 Union St Ste 100, Lafayette, IN 47904-2694 | 2006-08-22 |
| 1184730848 | Andrew C Perry | Podiatrist | 2020 Union St Ste 100, Lafayette, IN 47904-2694 | 2006-08-22 |
| 1215975891 | Mark Ellis | Podiatrist | 501 W Saint Mary Blvd, Suite B, Lafayette, LA 70506-4600 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063672327 | Edward Lang | Podiatrist | 2626 Jena St., New Orleans, LA 70115-6325 | 2008-06-11 |
| 1568651966 | Louisiana Medical Foot Center Associates Inc | Podiatrist | 110 Bellemeade Blvd, Suite A, Gretna, LA 70056-7142 | 2007-10-22 |
| 1386832822 | Dr Jonathan J Gisclair Apmc Dba Lafourche Podiatry Clinic | Podiatrist | 16148 W Main St, Cut Off, LA 70345-3511 | 2007-10-10 |
| 1841483666 | Charles Anthony Caplis | Podiatrist | 2520 Harvard Ave Ste 2b, Metairie, LA 70001-1172 | 2007-08-24 |
| 1467675124 | Baton Rouge Foot Care, PC | Podiatrist | 8160 Ymca Plaza Dr Ste C, Baton Rouge, LA 70810-0916 | 2007-04-11 |
| 1104957695 | The Foot Clinic of West Louisiana | Podiatrist | 901 Shirley Street, Deridder, LA 70634 | 2007-03-08 |
| 1942384227 | Minden Foot Clinic, Inc | Podiatrist | 603 Fleming Ln, Minden, LA 71055-3073 | 2006-10-24 |
| 1639190366 | Robert Jarrett Kadish | Podiatrist | 1521 N Causeway Blvd, Ste. A, Metairie, LA 70001-4135 | 2006-07-21 |
| 1639195639 | Darren Michael Vigee | Podiatrist | 985 Robert Blvd Ste 103, Slidell, LA 70458-2063 | 2006-07-14 |
| 1447289426 | Robert A. Arango | Podiatrist | 1717 Oak Park Blvd Fl 2, Lake Charles, LA 70601-8990 | 2006-07-01 |
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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.