NPI age
14 years
Enumerated 2011-06-02
● Active
Type 1 · Individual
DR. Clinton Ellingson, MD
Ellingson is 1 of 2 ophthalmology providers in Idaho Falls and 1 of 4 in Idaho.
Primary specialty
Ophthalmology
Plus 3 subspecialties
Licensed in
ID, KY, IN
3 states
Status
Active
No deactivations on record
Last NPPES update
2025-09-16
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 4 active ophthalmology providers in Idaho.
NPI age
14 years
↓ 1 yr below median (15 yr)
State licenses
3 states
Top 75% — 25% of peers are multi-state
Subspecialties
1
In the 50% of peers with subspecialties
NPI lifetime · 2011 → 2026
2011-06Enumerated in NPPES
2011
2026
Where they practice
Practice location
2100 Providence Way
Idaho Falls, ID 834044951
Mailing address
2100 Providence Way
Idaho Falls, ID 834044951
Additional practice locations
3 secondary locations on file with NPPES.
Location 2
214 W 1500 S Ste 300
Bountiful, UT 840107408
Location 3
4360 Washington Blvd
Ogden, UT 844031866
Location 4
6149 E Columbia St
Evansville, IN 47715
Specialties
-
Ophthalmology PrimaryAn ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
-
OphthalmologyAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (WV) | 1326332776 | |
| 05 (OH) | 0160321 | |
| 05 (ID) | 1326332776 | |
| 05 (KY) | 7100279250 | |
| 05 (IN) | 300021246 |
Multi-state credentialing: Licensed in 3 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
Provyx · Custom healthcare lists
Need all 4 Ophthalmology providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.