Active NPI
Megan Ellis
- Contractor
- Clarendon, AR
National Provider Identifier
1043686116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- PT2580
- Practice address
- 545 N Main St
Clarendon, AR 72029-2017 - Phone
- (870) 830-6805
- NPI assigned
- Aug 12, 2015
- Last updated
- Aug 12, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | PT2580 | AR | Primary |
Addresses
Primary practice location
545 N Main St
Clarendon, AR 72029-2017
Mailing address
545 N Main St
Clarendon, AR 72029-2017
Phone (870) 830-6805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT2580 | AR | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439337600000",
"number": "1043686116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 N MAIN ST",
"city": "CLARENDON",
"state": "AR",
"postal_code": "720292017",
"telephone_number": "870-830-6805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 N MAIN ST",
"city": "CLARENDON",
"state": "AR",
"postal_code": "720292017",
"telephone_number": "870-830-6805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "MEGAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-12",
"last_updated": "2015-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "AR",
"license": "PT2580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarendon, AR
- Baptist Health Hospitals (Baptist Health Family Clinic Clarendon)
- Clarendon Pharmacy Inc (Polk Pharmacy)
- Clarendon Public Schools
- Dewitt Hospital & Nursing Home, Inc
- Christina Kaye Dunlap
- Collyn George, M.S. CCC-SLP
- Leigh Ann Guest, APN, GNP
- Dylan Harrison
- Marla Henry, APN
- Christopher P. Hopkinson, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.