Individual provider Active NPI

Alanna Ellis, CRNP

  • Pediatric Nurse Practitioner
  • Wexford, PA
National Provider Identifier
1063957314
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
SP016828 Issued in PA
Practice address
9795 Perry Hwy
Ste 100
Wexford, PA 15090-9700
Phone
(412) 358-9548
Fax
(412) 366-5118
NPI assigned
Dec 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X SP016828 PA Primary

Addresses

Primary practice location

9795 Perry Hwy
Ste 100
Wexford, PA 15090-9700

Mailing address

9795 Perry Hwy
Ste 100
Wexford, PA 15090-9700
Phone (412) 358-9548

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

LicenseStateTypeSpecialty
SP016828PAMDPediatric Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: aellis172407@direct.ahn.org

NPI Registry JSON

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1063957314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9795 PERRY HWY",
            "address_2": "STE 100",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909700",
            "telephone_number": "412-358-9548",
            "fax_number": "412-366-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9795 PERRY HWY",
            "address_2": "STE 100",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150909700",
            "telephone_number": "412-358-9548",
            "fax_number": "412-366-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ALANNA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP016828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.