Active NPI
Sherry L Ellefson, CNP
- Specialist
- Bemidji, MN
National Provider Identifier
1235201252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- R1031751
- Practice address
- 1300 Anne St NW
Bemidji, MN 56601-5103 - Phone
- (218) 333-6011
- Fax
- (218) 333-6113
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | R1031751 | MN | Primary |
Addresses
Primary practice location
1300 Anne St NW
Bemidji, MN 56601-5103
Mailing address
1300 Anne St NW
Bemidji, MN 56601-5103
Phone (218) 333-6011
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)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1235201252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 ANNE ST NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566015103",
"telephone_number": "218-333-6011",
"fax_number": "218-333-6113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 ANNE ST NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566015103",
"telephone_number": "218-333-6011",
"fax_number": "218-333-6113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLEFSON",
"first_name": "SHERRY",
"middle_name": "L",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MN",
"license": "R1031751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bemidji, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.