Tara Lynn Ellis, RN

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

591941 Issued in NY

Practice address

23 Husky Lane
Malone, NY 12953

Phone

(518) 483-5230

NPI assigned

Sep 28, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Franklin-Essex-Hamilton Boces

  • Early Intervention Provider Agency
  • Malone, NY
  • NPI 1508006800
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506556800000",
    "number": "1003325424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 PORTER RD",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129533804",
            "telephone_number": "15184835230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 HUSKY LANE",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "12953",
            "telephone_number": "518-483-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2017-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "591941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leisa Kay Dwyer, RN
• Brandon D Eggleston
• Elizabeth Marie Eggleston, LCSW, CASAC II
• Darby Eldridge
• Kristin L Ellis-Wood, RD, CDN
• Gary Frank Epstein, DDS
• Jessica Euber, RN
• Eyecare for the Adirondacks
• Cherie Ann Fairchild, RN
• Nicole Marie Falardeau

• School Registered Nurse in Malone, NY
• Providers in Malone, NY by specialty
• School Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.