Individual provider Active NPI

Ellen Ann Gallup

  • Home Health Aide
  • Chagrin Falls, OH
National Provider Identifier
1154909935
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
4389 Orangedale Rd
Chagrin Falls, OH 44022-1438
Phone
(216) 470-2769
NPI assigned
Apr 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X Primary

Addresses

Primary practice location

4389 Orangedale Rd
Chagrin Falls, OH 44022-1438

Mailing address

4389 Orangedale Rd
Chagrin Falls, OH 44022-1438
Phone (216) 470-2769

Other identifiers 2

IdentifierTypeStateIssuer
1831516OtherOHOHIO DODD CONTRACT NUMBER
0383335MedicaidOH

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": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1154909935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4389 ORANGEDALE RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440221438",
            "telephone_number": "216-470-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4389 ORANGEDALE RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440221438",
            "telephone_number": "216-470-2769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLUP",
        "first_name": "ELLEN",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO DODD CONTRACT NUMBER",
            "identifier": "1831516",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0383335",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chagrin Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2021; 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.