Active NPI 1679595144 Individual Practitioner Male Practitioner

Dr. Bobby J Ellis , MD

Internal Medicine • Ardmore, OK

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Bobby Ellis, MD is a certified Internal Medicine practicing in Ardmore, OK. With approximately 46 years of clinical experience since graduating from University Of Kansas School Of Med (Kc/Wich/Sal) in 1980, Dr. Ellis delivers high-quality medical care to the local community at 921 14TH AVE NW.

Dr. Ellis is affiliated with Mercy Clinic Oklahoma Communities and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit, physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

921 14th Ave Nw

Ardmore, OK 734011837

Telephone 5802235311

Fax 5802238227

Associated Practice Facility / Clinic

🏢 Medical Arts Clinic Of Ardmore Inc Facility NPI 1457331175

Medicare Profile & Education

Medical School

University Of Kansas School Of Med (Kc/wich/sal)

Graduation Year

1980

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Ardmore, OK

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

46 Yrs +17.6 yrs vs City Avg

City Avg: 28.4 Yrs

State Avg: 26.0 Yrs

Regional Practice Density

14 Specialists

Practicing in Ardmore, OK (1179 Statewide)

Telehealth Adoption Rate

21.4% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

47.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Ellis (46 Years) 46 Yrs

Ardmore Specialty Average (28.4 Years) 28.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	759	334	$183.41	$117.57
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	227	227	$310.54	$118.89
99213 Established patient office or other outpatient visit, typically 15 minutes	128	100	$127.63	$82.73
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	86	38	$103.00	$38.27
G0008 Administration of influenza virus vaccine	83	82	$41.00	$30.07
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	80	67	$37.00	$15.44
90662 Influenza vaccine split virus, preservative free	76	75	$95.00	$81.43
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	40	39	$136.00	$49.19
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	18	15	$46.00	$12.17
71046 X-ray of chest, 2 views	14	14	$44.00	$20.10
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	12	12	$260.00	$155.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	901	386	$183.97	$120.51
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	289	289	$311.00	$114.75
99213 Established patient office or other outpatient visit, typically 15 minutes	231	151	$129.00	$84.08
G0008 Administration of influenza virus vaccine	129	125	$41.00	$28.68
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	123	56	$103.00	$38.62
90662 Influenza vaccine split virus, preservative free	93	90	$94.68	$71.75
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	59	49	$136.00	$49.12
J1100 Injection, dexamethasone sodium phosphate, 1 mg	54	12	$1.00	$0.12
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	36	24	$46.00	$12.50
G0009 Administration of pneumococcal vaccine	29	29	$41.00	$28.68
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	23	23	$529.00	$279.94
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	20	20	$49.00	$21.82
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	16	16	$260.00	$157.91
90694 Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage	16	16	$122.00	$75.81
71046 X-ray of chest, 2 views	13	13	$44.00	$20.55
77080 Dxa bone density measurement of hip, pelvis, spine	12	12	$112.25	$34.27
93000 Routine ekg using at least 12 leads including interpretation and report	11	11	$34.91	$13.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	921	409	$183.95	$120.63
99213 Established patient office or other outpatient visit, typically 15 minutes	308	183	$128.93	$84.87
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	268	268	$258.11	$124.12
G0008 Administration of influenza virus vaccine	211	205	$41.00	$27.19
90662 Influenza vaccine split virus, preservative free	184	178	$88.80	$68.21
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	137	57	$103.00	$38.43
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	64	54	$136.00	$50.02
G0009 Administration of pneumococcal vaccine	63	63	$41.00	$27.30
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	31	29	$46.00	$13.47
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	27	27	$49.00	$21.05
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	26	26	$175.81	$132.19
71046 X-ray of chest, 2 views	25	22	$44.00	$21.02
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	24	24	$529.00	$278.52
77080 Dxa bone density measurement of hip, pelvis, spine	17	17	$110.76	$33.59
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	16	16	$331.50	$160.30
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$258.93	$159.57
93000 Routine ekg using at least 12 leads including interpretation and report	14	13	$34.00	$13.46
90670 Pneumococcal vaccine for injection into muscle	13	13	$333.00	$251.66
72110 X-ray of lower and sacral spine, minimum of 4 views	12	12	$108.00	$35.38
0001A Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, diluent reconstituted; first dose	11	11	$72.36	$36.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,139	480	$173.81	$122.88
99213 Established patient office or other outpatient visit, typically 15 minutes	336	188	$122.10	$86.75
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	299	299	$206.00	$126.21
36415 Insertion of needle into vein for collection of blood sample	271	206	$12.00	$2.99
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	200	77	$103.00	$38.74
G0008 Administration of influenza virus vaccine	192	191	$41.00	$15.73
90662 Influenza vaccine split virus, preservative free	175	174	$87.00	$65.19
J1100 Injection, dexamethasone sodium phosphate, 1 mg	172	30	$1.28	$0.16
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	100	76	$136.00	$50.25
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	97	69	$46.00	$13.35
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	84	21	$5.00	$1.25
J0696 Injection, ceftriaxone sodium, per 250 mg	64	16	$3.00	$0.54
G0009 Administration of pneumococcal vaccine	45	44	$41.00	$15.76
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	43	43	$175.00	$124.80
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	30	30	$49.00	$20.40
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	30	30	$256.27	$160.25
71046 X-ray of chest, 2 views	27	27	$44.00	$20.66
99496 Transitional care management services for problem of high complexity	23	23	$363.26	$256.80
77080 Dxa bone density measurement of hip, pelvis, spine	22	22	$110.41	$34.05
0001A Intramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 30 mcg/0.3ml dosage, diluent reconstituted; first dose	21	21	$55.67	$36.94
90670 Pneumococcal vaccine for injection into muscle	16	16	$333.00	$241.38
0011A Adm sarscov2 100mcg/0.5ml1st	15	15	$57.20	$36.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,289	507	$164.50	$104.16
36415 Insertion of needle into vein for collection of blood sample	738	408	$12.00	$2.98
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	341	341	$206.00	$111.33
99213 Established patient office or other outpatient visit, typically 15 minutes	334	170	$111.99	$69.84
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	251	92	$103.00	$38.94
G0008 Administration of influenza virus vaccine	237	233	$40.90	$15.76
90662 Influenza vaccine split virus, preservative free	215	213	$87.00	$60.78
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	83	76	$136.00	$51.04
J1100 Injection, dexamethasone sodium phosphate, 1 mg	72	15	$5.00	$0.12
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	68	17	$5.00	$1.47
G0009 Administration of pneumococcal vaccine	60	60	$39.87	$15.61
99496 Transitional care management services for problem of high complexity	60	53	$361.20	$234.35
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	49	39	$46.00	$13.20
87804 Detection test by immunoassay with direct visual observation for influenza virus	46	22	$51.00	$15.33
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	46	46	$159.24	$115.92
99441 Telephone medical discussion with physician, 5-10 minutes	30	30	$23.00	$22.95
71046 X-ray of chest, 2 views	29	26	$44.00	$19.18
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	26	24	$49.00	$19.40
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$251.00	$152.97
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	19	19	$309.00	$164.42
72110 X-ray of lower and sacral spine, minimum of 4 views	17	17	$108.00	$31.89
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	17	17	$51.00	$14.94
99442 Telephone medical discussion with physician, 11-20 minutes	17	17	$48.00	$45.50
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic	15	15	$33.00	$14.10
90670 Pneumococcal vaccine for injection into muscle	15	15	$295.67	$216.93
73502 X-ray of hip, 2-3 views	14	14	$54.14	$30.55
99495 Transitional care management services for problem of at least moderate complexity	13	13	$262.46	$176.98
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$164.64	$89.44

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,661	540	$162.40	$103.68
36415 Insertion of needle into vein for collection of blood sample	812	416	$12.00	$2.94
99213 Established patient office or other outpatient visit, typically 15 minutes	368	191	$110.87	$69.62
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	316	316	$206.00	$109.37
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	196	67	$103.00	$38.97
G0008 Administration of influenza virus vaccine	181	179	$39.00	$15.46
90662 Influenza vaccine split virus, preservative free	145	145	$86.86	$54.85
G0009 Administration of pneumococcal vaccine	110	109	$39.00	$15.46
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	81	72	$136.00	$50.77
J1100 Injection, dexamethasone sodium phosphate, 1 mg	80	16	$5.00	$0.13
99496 Transitional care management services for problem of high complexity	69	54	$358.00	$221.14
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	66	66	$145.48	$110.49
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	59	42	$46.00	$15.56
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	48	12	$5.00	$1.58
90670 Pneumococcal vaccine for injection into muscle	43	43	$276.44	$208.92
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	35	35	$309.00	$164.71
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	33	33	$49.00	$18.65
71046 X-ray of chest, 2 views	32	29	$44.00	$18.19
99495 Transitional care management services for problem of at least moderate complexity	27	26	$254.00	$156.51
73562 X-ray of knee, 3 views	25	18	$82.00	$25.01
72110 X-ray of lower and sacral spine, minimum of 4 views	18	18	$108.00	$31.73
G0402 Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment	16	16	$269.13	$146.89
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$248.53	$158.37
73502 X-ray of hip, 2-3 views	13	13	$53.00	$28.52
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$162.54	$97.11
93000 Routine ekg using at least 12 leads including interpretation and report	12	12	$33.58	$16.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,786	580	$161.00	$101.52
36415 Insertion of needle into vein for collection of blood sample	911	457	$12.00	$2.94
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	274	274	$206.00	$110.03
G0008 Administration of influenza virus vaccine	211	208	$39.00	$18.90
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	165	64	$103.00	$39.08
99213 Established patient office or other outpatient visit, typically 15 minutes	153	128	$109.00	$67.16
90653 Vaccine for influenza for injection into muscle	149	149	$76.00	$53.58
G0009 Administration of pneumococcal vaccine	104	103	$39.00	$18.90
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	98	98	$309.00	$162.79
99496 Transitional care management services for problem of high complexity	63	53	$358.00	$219.59
77080 Dxa bone density measurement of hip, pelvis, spine	63	63	$126.14	$38.06
90670 Pneumococcal vaccine for injection into muscle	54	54	$275.00	$198.07
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	51	43	$136.00	$50.68
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	49	49	$140.02	$105.59
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	46	25	$46.00	$19.03
90662 Influenza vaccine split virus, preservative free	45	45	$74.33	$51.54
71046 X-ray of chest, 2 views	41	34	$44.00	$17.43
72110 X-ray of lower and sacral spine, minimum of 4 views	21	21	$111.71	$29.49
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	18	18	$248.00	$157.32
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	16	16	$49.00	$18.65
99495 Transitional care management services for problem of at least moderate complexity	16	16	$260.50	$154.89
G0506 Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service)	15	14	$151.00	$59.99
J1030 Injection, methylprednisolone acetate, 40 mg	13	13	$8.38	$6.67
93000 Routine ekg using at least 12 leads including interpretation and report	13	11	$41.77	$15.85
72052 X-ray of upper spine, 6 or more views	12	11	$129.00	$33.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	1,839	618	$161.00	$100.36
36415 Insertion of needle into vein for collection of blood sample	1,043	473	$12.00	$2.94
G0008 Administration of influenza virus vaccine	199	195	$38.88	$23.05
G0179 Physician re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial imp	175	63	$103.00	$38.37
90662 Influenza vaccine split virus, preservative free	174	171	$62.00	$47.66
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	162	162	$206.00	$108.04
99213 Established patient office or other outpatient visit, typically 15 minutes	119	101	$109.00	$68.42
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	108	108	$309.00	$160.32
G0009 Administration of pneumococcal vaccine	88	88	$38.39	$23.05
99496 Transitional care management services for problem of high complexity	82	65	$358.00	$213.52
71020 X-ray of chest, 2 views, front and side	49	45	$71.12	$22.17
G0180 Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and	47	44	$136.00	$50.16
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	44	44	$131.00	$94.69
90670 Pneumococcal vaccine for injection into muscle	43	43	$275.00	$185.36
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	32	15	$45.72	$23.19
73562 X-ray of knee, 3 views	25	20	$107.28	$29.39
77080 Dxa bone density measurement of hip, pelvis, spine	22	18	$102.77	$30.13
93000 Routine ekg using at least 12 leads including interpretation and report	21	21	$71.00	$15.72
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	19	19	$248.00	$147.90
99495 Transitional care management services for problem of at least moderate complexity	17	15	$254.00	$152.47
90686 Vaccine for influenza for administration into muscle, 0.5 ml dosage	14	14	$49.00	$18.65
73502 X-ray of hip, 2-3 views	13	12	$68.23	$34.16
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$161.00	$101.39
74022 Complete x-ray study of abdomen with single x-ray of chest	12	12	$116.42	$35.48
90688 Vaccine for influenza for administration into muscle, 0.5 ml dosage	11	11	$34.00	$17.48
72110 X-ray of lower and sacral spine, minimum of 4 views	11	11	$132.27	$40.24

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License OK 26021

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Internal Medicine

NUCC Taxonomy Code: 207R00000X

State License KS 0417821

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

200128140A (OK)

Hospital & Practice Group Affiliations

Mercy Clinic Oklahoma Communities

1020 N Commerce St, Ardmore, OK 734013920

Phone: 5802235311

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

13 Associated Practitioners

Dr. Toribio Velasquez , MD

Internal Medicine

NPI 1194779975

Doctor of Medicine (M.D.)

Dr. Wilfred Gauthier , MD, FACS

Surgery

NPI 1235176629

Doctor of Medicine (M.D.), FACS

Dr. Brooks Zimmerman , DO

Family Medicine

NPI 1306845367

Doctor of Osteopathic Medicine (D.O.)

Sallie Walker , MS, RN, ARNP

Nurse Practitioner - Family

NPI 1306889878

Master of Science, Registered Nurse, Advanced Registered Nurse Practitioner

S Dawnita Sampson , APRN-CNP

Nurse Practitioner - Family

NPI 1366938391

Advanced Practice Registered Nurse - Certified Nurse Practitioner

Dr. Summer Kirby , MD

Family Medicine

NPI 1376703595

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active April 29, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location April 29, 2014

Registered at 921 14TH AVE NW, ARDMORE, OK 734011837 (Tel: 5802235311)

📍

Updated Business Mailing Address April 29, 2014

Registered at 4401 W MEMORIAL RD, 140, OKLAHOMA CITY, OK 731341785 (Tel: 4057523162)

👤

Provider Name / Credentials Updated April 29, 2014

Recorded as BOBBY ELLIS, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 29, 2014

Internal Medicine (License #26021 in OK)

🟢

Initial NPI Registration & Enumeration July 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1679595144

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 24, 2006

Last Update: April 29, 2014

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

4401 W Memorial Rd, 140

Oklahoma City, OK 731341785

Phone: 4057523162

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.