Katherine Ellis

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

22035 Issued in SC

Practice address

2016 1St Ave
Summerville, SC 29486-0408

Phone

(843) 432-3109

NPI assigned

Jul 10, 2018

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

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kellis@sp.gwaydirect.com

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.

• Sweetgrass Pediatrics

  • Pediatrics Physician
  • North Charleston, SC
  • NPI 1437168135
  NPD (past)

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1043706393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 1ST AVE",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294860408",
            "telephone_number": "843-432-3109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 1ST AVE",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294860408",
            "telephone_number": "843-432-3109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "22035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonne Ellington
• Corinne Elliott, FNP-C
• Kim Marie Elliott
• Mattie Devin Elliott, COTA/L
• Melissa Rose Ellis-Yarian, D.O
• Elodie LLC
• Brian David Elston, PA-C
• Stacie Nettles Elwood, ATC
• Empowered Communications, LLC
• Nicole Encarnacion

• Pediatric Nurse Practitioner in Summerville, SC
• Providers in Summerville, SC by specialty
• Pediatric Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.