Anthony Ellis, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95007645 Issued in CA

Practice address

2105 Forest Ave
San Jose, CA 95128-1425

Phone

(408) 947-2500

NPI assigned

Oct 7, 2017

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1507334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507334400000",
    "number": "1063922771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44280 REVERE PL",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945395902",
            "telephone_number": "510-387-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 FOREST AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281425",
            "telephone_number": "408-947-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ANTHONY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-07",
        "last_updated": "2017-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95007645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica A Elliott
• Peter Albert Elliott, MD
• Ricci Rene Elliott
• Terri Elliott
• Adrianna Ellis
• Brendan Todd Ellis, MFT
• Kimberly Ellis
• Nicole Ellis
• Pamela Ellis
• Steven B Elman

• Family Nurse Practitioner in San Jose, CA
• Providers in San Jose, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2017; 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.