Ellen Tyesha Arnold, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.017824 Issued in IL

Practice address

800 Devon Ave
Park Ridge, IL 60068-4760

Phone

(800) 323-8622

NPI assigned

Aug 1, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ellen.anrold.p1@direct.katzeneye.nextgenshare.com
• Direct secure messaging: earnold225708@direct.myadvocateaurora.org

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.

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  • NPI 1497701882
  Medicare reassignment NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
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  • NPI 1265695944
  NPD

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1043798036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 E FOREST AVE",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600181470",
            "telephone_number": "502-418-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 DEVON AVE",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684760",
            "telephone_number": "800-323-8622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3637 N Southport Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606133709",
            "country_code": "US",
            "telephone_number": "773-348-5282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9977 Woods Dr",
            "address_purpose": "LOCATION",
            "city": "Skokie",
            "state": "IL",
            "postal_code": "60077",
            "country_code": "US",
            "telephone_number": "224-364-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "153 1/2 N 19th Ave",
            "address_purpose": "LOCATION",
            "city": "Melrose Park",
            "state": "IL",
            "postal_code": "60160",
            "country_code": "US",
            "telephone_number": "708-345-8960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "153 1/2 N 19th Ave",
            "address_purpose": "LOCATION",
            "city": "Melrose Park",
            "state": "IL",
            "postal_code": "60160",
            "country_code": "US",
            "telephone_number": "708-345-8960",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6150 N Broadway St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606602538",
            "country_code": "US",
            "telephone_number": "866-389-3272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "ELLEN",
        "middle_name": "TYESHA",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-01",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.017824",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041378473",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "earnold225708@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "800 Devon Ave",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600684760",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "800 Devon Ave",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600684760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy S. Archer, M.D.
• Monica M Argumedo, M.D.
• Stephanie Arias, OTR
• Ariava LLC
• Istiklal Arikan, MD
• Richard Aronoff, ED.D.
• Yuri Aronov, MD
• Patricia Alejandra Arroyo Parejo Drayer, M.D.
• Alma Arslanagic, M.D.
• Alexander A Artisuk, D.D.S.

• Family Nurse Practitioner in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.