Individual provider Active NPI

Karyssa Marie Ellis

  • Speech-Language Pathologist
  • Greenville, NC
National Provider Identifier
1164330130
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
30005615 Issued in NC
Practice address
1540 E Arlington Blvd
Greenville, NC 27858-5870
Phone
(252) 364-2806
Fax
(252) 364-2863
NPI assigned
Aug 31, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 30005615 NC Primary

Addresses

Primary practice location

1540 E Arlington Blvd
Greenville, NC 27858-5870

Mailing address

1540 E Arlington Blvd
Greenville, NC 27858-5870
Phone (252) 364-2806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1164330130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 E ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585870",
            "telephone_number": "252-364-2806",
            "fax_number": "252-364-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 E ARLINGTON BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585870",
            "telephone_number": "252-364-2806",
            "fax_number": "252-364-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KARYSSA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30005615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.