Desirae Serene Ellison

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

2018-3632 Issued in WV

Practice address

21 Mallard CT
Beckley, WV 25801-3615

Phone

(304) 890-8020

Fax

(681) 207-7029

NPI assigned

Jan 13, 2023

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• On Point Acupuncture, PLLC

  • Acupuncturist
  • Beckley, WV
  • NPI 1528439056
  NPD

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1093420028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 OKEY L PATTESON RD",
            "city": "SCARBRO",
            "state": "WV",
            "postal_code": "259178022",
            "telephone_number": "304-520-1426",
            "fax_number": "681-207-7029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MALLARD CT",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013615",
            "telephone_number": "304-890-8020",
            "fax_number": "681-207-7029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "DESIRAE",
        "middle_name": "SERENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WV",
            "license": "2018-3632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "onpointacupunctureclinic@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21 Mallard Ct",
            "city": "Beckley",
            "state": "WV",
            "country_code": "US",
            "postal_code": "258013615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• James R Ellis, ANP-BC
• Kriston Ellis
• Michelle Ellis, FNP-BC
• Nikki Ellis, MA, CCC-SLP
• Wayne Enoch Ellis, PH.D., CRNA
• Mini Jacob Elnaggar, M.D.
• Caitlin Renee Elswick, LGSW
• Elynyx LLC
• Elynyx LLC
• Elynyx LLC

• Massage Therapist in Beckley, WV
• Providers in Beckley, WV by specialty
• Massage Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.