Anne Callis Ellis, BSN RN

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

041477985 Issued in IL

Practice address

227 W Poplar St
Harrisburg, IL 62946-1421

Phone

(618) 552-9841

NPI assigned

Nov 3, 2023

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 3, 2023.

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1013780758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 W POPLAR ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629461421",
            "telephone_number": "618-294-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 W POPLAR ST",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629461421",
            "telephone_number": "618-552-9841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ANNE",
        "middle_name": "CALLIS",
        "credential": "BSN RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "IL",
            "license": "041477985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Michael J. Gearing D.D.S. Inc
• Egyptian Health Department
• Egyptian Health Department
• Egyptian Health Department
• Ellet Pharmacy Inc
• Empowerme Rehabilitation Illinois, LLC
• Ethan Grounds DMD PC
• Timothy Etienne, RPH
• Eubanks & Daugherty, LLC
• Krystina Lee Eubanks, O.D.

• All providers in Harrisburg, IL
• Administrator Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.