Individual provider Active NPI

Sheridan Louise Ely, RN, FNP-C

  • Family Nurse Practitioner
  • Houston, TX
National Provider Identifier
1215181052
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
223793 Issued in TX
Practice address
505 Maxey Rd
Houston, TX 77013-5072
Phone
(713) 681-3599
NPI assigned
Nov 6, 2008
Last updated
Apr 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 223793 TX Primary

Addresses

Primary practice location

505 Maxey Rd
Houston, TX 77013-5072

Mailing address

PO Box 2
708 Cedar St
Hearne, TX 77859-0002
Phone (979) 279-3940

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
223793TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1215181052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2",
            "address_2": "708 CEDAR ST",
            "city": "HEARNE",
            "state": "TX",
            "postal_code": "778590002",
            "telephone_number": "979-279-3940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 MAXEY RD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770135072",
            "telephone_number": "713-681-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELY",
        "first_name": "SHERIDAN",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "RN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "223793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.