Delisa Ellis

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

2100 Oliver Rd
Monroe, LA 71201-3628

Phone

(318) 322-0301

Fax

(318) 322-0571

NPI assigned

Jun 16, 2016

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)

Not enrolled

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1134579550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 CARDINAL ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712706218",
            "telephone_number": "318-533-2481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 OLIVER RD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013628",
            "telephone_number": "318-322-0301",
            "fax_number": "318-322-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "DELISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arma Ellis, BA
• Christopher Ellis
• Crystal R Ellis, OT
• Deedrick Ellis
• Dekara Ellis
• Gerri Thomas Ellis, CRNA
• Lashanda Lasha Ellis, LMSW
• Shaquita Ellis, NP
• Sholanda Ellis, CSW
• Amin Elmalah, M.D.

• All providers in Monroe, LA
• Community Health Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.