Active NPI
Emily Rose Ennis, MT-BC
- Music Therapist
- Queensbury, NY
National Provider Identifier
1316720972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Music Therapist
- License
- 16901
- Practice address
- 165 Farr LN
Queensbury, NY 12804-1996 - Phone
- (518) 409-5491
- NPI assigned
- Aug 17, 2023
- 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 |
|---|---|---|---|---|
| Music Therapist | 225A00000X | 16901 | NY | Primary |
Addresses
Primary practice location
165 Farr LN
Queensbury, NY 12804-1996
Mailing address
165 Farr LN
Queensbury, NY 12804-1996
Phone (518) 409-5491
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16901 | NY | MD | Music Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692230400000",
"number": "1316720972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "165 FARR LN",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128041996",
"telephone_number": "518-409-5491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 FARR LN",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128041996",
"telephone_number": "518-409-5491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENNIS",
"first_name": "EMILY",
"middle_name": "ROSE",
"name_prefix": "Miss",
"credential": "MT-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-17",
"last_updated": "2023-08-17",
"certification_date": "2023-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": "NY",
"license": "16901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queensbury, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.