1386227098 NPI number — DR. CHRISTINE ANABELLE ELLIS M.D.

Table of content: DR. CHRISTINE ANABELLE ELLIS M.D. (NPI 1386227098)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386227098 NPI number — DR. CHRISTINE ANABELLE ELLIS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ELLIS
Provider First Name:
CHRISTINE
Provider Middle Name:
ANABELLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ELLIS
Provider Other First Name:
CHRISTINE
Provider Other Middle Name:
ANABELLE ANOWA
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1386227098
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ST. MARY MEDICAL CENTER, 1201 LANGHORNE-NEWTOWN RD
Provider Second Line Business Mailing Address:
STE 1
Provider Business Mailing Address City Name:
LANGHORNE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19047-1295
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3377 RIVERBEND DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97477-8803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-222-6389
Provider Business Practice Location Address Fax Number:
541-222-6385
Provider Enumeration Date:
04/30/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: MD223378 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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