Donna Ellis, OGNP

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

800002 Issued in NC

Practice address

371 NC Hwy 65
Ste 204
Wentworth, NC 27320

Phone

(336) 342-8140

Fax

(336) 342-8128

NPI assigned

Oct 17, 2006

Last updated

Nov 25, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rockingham County Finance Office

  dba Rockingham County Public Health

  • State or Local Public Health Clinic/Center
  • Wentworth, NC
  • NPI 1043366891
  NPD (past)
• Rockingham County Finance Office

  dba Rockingham County Public Health

  • State or Local Public Health Clinic/Center
  • Reidsville, NC
  • NPI 1306947445
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259107200000",
    "number": "1275614489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 204",
            "city": "WENTWORTH",
            "state": "NC",
            "postal_code": "273750204",
            "telephone_number": "336-342-8140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 NC HWY 65",
            "address_2": "STE 204",
            "city": "WENTWORTH",
            "state": "NC",
            "postal_code": "27320",
            "telephone_number": "336-342-8140",
            "fax_number": "336-342-8128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "DONNA",
        "credential": "OGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2009-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NC",
            "license": "800002",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "800002",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NC",
            "license": "800002",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATION",
            "identifier": "21258",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "800002",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Moorefield Cashatt, RN
• Brenda B Clark, PHYSICIANS ASSISTANT
• Nina Coleman
• Lynda Mann Cook, LCAS
• Stephanie Croom, RN
• Mary Katherine Fuget, RN
• Theresa Garrett
• Holly Meredith Goss, LPC-BE
• Janet Hall, LCAS-P
• Bobbie Jo Harris, RN

• Obstetrics & Gynecology Nurse Practitioner in Wentworth, NC
• Providers in Wentworth, NC by specialty
• Obstetrics & Gynecology Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.