Individual provider Active NPI

Andrea Ellison

  • Acupuncturist
  • Stone Ridge, NY
National Provider Identifier
1114448057
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
005981 Issued in NY
Practice address
8 Sun Creek LN
Stone Ridge, NY 12484-5639
Phone
(845) 750-8700
NPI assigned
Jun 30, 2017
Last updated
Jun 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 005981 NY Primary

Addresses

Primary practice location

8 Sun Creek LN
Stone Ridge, NY 12484-5639

Mailing address

8 Sun Creek LN
Stone Ridge, NY 12484-5639
Phone (845) 750-8700

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

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498780800000",
    "number": "1114448057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 SUN CREEK LN",
            "city": "STONE RIDGE",
            "state": "NY",
            "postal_code": "124845639",
            "telephone_number": "845-750-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 SUN CREEK LN",
            "city": "STONE RIDGE",
            "state": "NY",
            "postal_code": "124845639",
            "telephone_number": "845-750-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-30",
        "last_updated": "2017-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NY",
            "license": "005981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Ridge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.