Amanda Ellis

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1902 Central Ave
Fairbanks, AK 99709-4223

Phone

(907) 398-7297

NPI assigned

Aug 13, 2021

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

Practice roles

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.

• Fairbanks Community Care Coordination

  • Case Management Agency
  • Fairbanks, AK
  • NPI 1013684414
  NPD Authorized official

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629244800000",
    "number": "1053086736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80929",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997080929",
            "telephone_number": "907-398-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 CENTRAL AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094223",
            "telephone_number": "907-398-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-18",
        "certification_date": "2021-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "AK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather E Eisenman, MS CCC-SLP
• Rose Elizabeth Elbert, LPC
• Joshua Eldred
• Elemental Balance LLC
• Rita Marie Ellington, PSY.D., CDCS, ADMN
• Jennifer Ellison
• Brandy Jean Ells, MA
• Kathie C Elmore
• Richard Elson
• Floyd Elterman, MD

• Case Manager/Care Coordinator in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Case Manager/Care Coordinator in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2021; 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.