NPIMap

Organization Active NPI

S. Ellis Healthcare Services, LLC

  • Home Health Agency
  • Conyers, GA
National Provider Identifier
1023397205
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
122-R-0901 Issued in GA
Legal business name
S. ELLIS HEALTHCARE SERVICES, LLC
Practice address
1233 Salem Gate Drive
Conyers, GA 30013-1362
Phone
(770) 679-5714
Fax
(888) 273-6606
NPI assigned
Aug 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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

Authorized official

Name
Ms. Selina Yvette EllisNPI 1326343765
Title
Owner/Adminstrator
Phone
(770) 679-5714

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 122-R-0901 GA Primary

Addresses

Primary practice location

1233 Salem Gate Drive
Conyers, GA 30013-1362

Mailing address

PO Box 81314
Conyers, GA 30013-9314
Phone (770) 679-5714

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454457600000",
    "number": "1023397205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81314",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300139314",
            "telephone_number": "770-679-5714",
            "fax_number": "888-273-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 SALEM GATE DRIVE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300131362",
            "telephone_number": "770-679-5714",
            "fax_number": "888-273-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. ELLIS HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-05",
        "last_updated": "2016-02-03",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "SELINA",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "OWNER/ADMINSTRATOR",
        "authorized_official_telephone_number": "770-679-5714",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "122-R-0901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.