Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary C Ellis, MD

Individual provider Behavior Analyst · NPI 1376146837

Mary C Ellis, MD is a Behavior Analyst in Caldwell, Idaho. Licensed in Idaho. Registered with an NPI since 2020.

Licensed in
ID
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

11080 Roaring Fork St
Caldwell, ID 83605-2078
Phone: (949) 306-7962
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Analyst (primary) Taxonomy 103K00000X (ID)

Record details

NPI number1376146837
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 18, 2020
Last updated in NPPESJune 5, 2025
Certification dateMay 20, 2025
Mailing address11080 Roaring Fork St, Caldwell, ID 83605-2078

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