Ellis Family Id Services Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

ELLIS FAMILY ID SERVICES INC.

Practice address

3925 Poplar Grove Rd
Maryville, TN 37804-4701

Phone

(865) 724-7208

NPI assigned

Feb 1, 2023

Organization subpart

No

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

Authorized official

Name

Wanda K. Ellis

Title

Owner/Treasure

Phone

(865) 724-6748

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1134825151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 POPLAR GROVE RD",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378044701",
            "telephone_number": "865-724-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 POPLAR GROVE RD",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378044701",
            "telephone_number": "865-724-7208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3925 Poplar Grove Rd",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "TN",
            "postal_code": "378044701",
            "country_code": "US",
            "telephone_number": "865-724-7208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELLIS FAMILY ID SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-01",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "OWNER/TREASURE",
        "authorized_official_telephone_number": "865-724-6748"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Edmond
• Emery Edmondson, DO
• Grace Ann Rose Eldridge
• Ainsley Ellington, RN, IBCLC
• Matthew Allen Elliott, PTA
• Dustin Tyler Ellison
• Nicolas Robert Ellsworth
• Dale Bryant Elmore, M.D.
• John L Emert, DDS
• Anastasia Emms, LMT

• In Home Supportive Care Agency in Maryville, TN
• Providers in Maryville, TN by specialty
• In Home Supportive Care Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.