Nicole Anne Ellis, M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

105 Victory Rd
Dorchester, MA 02122-3518

Phone

(617) 371-3010

Fax

(617) 371-3044

NPI assigned

Mar 18, 2010

Last updated

Mar 18, 2010By the provider in NPPES

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)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1268870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1134443120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 VICTORY RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223518",
            "telephone_number": "617-371-3010",
            "fax_number": "617-371-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VICTORY RD",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021223518",
            "telephone_number": "617-371-3010",
            "fax_number": "617-371-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-18",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Omar Eldakroury
• Mugtaba Babiker Elghoth
• Rylie E Ellam
• Elliott Physical Therapy, Inc.
• Dominique Ellis
• Rosaida Ellis
• Abigail Elmes, PHARMD
• Darryl Elow
• Ahmed Elsabbagh, MD
• Emelcia's Daughters' Skilled Healthcare Agency LLC

• Speech-Language Pathologist in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Speech-Language Pathologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.