Elexis Dawn Enis

Key facts

NPI

1184243149

Entity type

Individual (NPI type 1)

Primary specialty

In Home Supportive Care Agency 253Z00000X

Practice address

823 Midwest Avenue
Mills, WY 82644

Phone

(307) 251-9972

NPI assigned

Apr 10, 2020

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 10, 2020.

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1184243149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 283",
            "city": "MILLS",
            "state": "WY",
            "postal_code": "826440283",
            "telephone_number": "307-251-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "823 MIDWEST AVENUE",
            "city": "MILLS",
            "state": "WY",
            "postal_code": "82644",
            "telephone_number": "307-251-9972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENIS",
        "first_name": "ELEXIS",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "WY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Mills, WY · In Home Supportive Care Agency in Wyoming