Laura Ellis, MSN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN050577 Issued in GA

Practice address

1100 Johnson Ferry Rd NE
Suite 600
Sandy Springs, GA 30342-1709

Phone

(404) 256-4777

Fax

(404) 256-5515

NPI assigned

Jan 10, 2006

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

Other identifiers 2

Other names 1

• Ms. Laura Green Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northside Hospital, Inc.

  dba The Pharmacy Center

  • Community/Retail Pharmacy
  • Atlanta, GA
  • NPI 1073572723
  NPD (past)
• Northside Imaging LLC

  • Diagnostic Radiology Physician
  • Warner Robins, GA
  • NPI 1316394976
  NPD (past)

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294963200000",
    "number": "1174502124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 SAVOY DR",
            "address_2": "SUITE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303411072",
            "telephone_number": "770-496-9400",
            "fax_number": "770-496-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FERRY RD NE",
            "address_2": "SUITE 600",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303421709",
            "telephone_number": "404-256-4777",
            "fax_number": "404-256-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2011-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN050577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP-DMERC",
            "identifier": "CA9328",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000885739C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "GREEN",
            "prefix": "MS.",
            "credential": "MSN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eliora Home Care LLC
• Elite Care Concierge, LLC
• Elite Chiropractic LLC
• Elite Health Solutions, LLC
• Lashaun Denise Elliott, M.D.
• Ellison Act Group, LLC
• William Elmore, NP, DC
• Ibrahim Khairy Fayed Elshamly, SC-A
• Emerald Integrative Therapy Services, LLC (Emerald Integrative Therapy Services)
• Empowerment Center for Greatness

• Nurse Practitioner in Sandy Springs, GA
• Providers in Sandy Springs, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2011; 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.