Nicole Elliott

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

201141590RN Issued in OR

Practice address

1003 E Main St Ste 104
Medford, OR 97504-7140

Phone

(541) 779-1282

Fax

(541) 608-2888

NPI assigned

May 17, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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 and National Provider Directory roles.

• Addictions Recovery Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Medford, OR
  • NPI 1346282035
  NPD (past)

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1326495607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 E MAIN ST STE 104",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047140",
            "telephone_number": "541-779-1282",
            "fax_number": "541-608-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E MAIN ST STE 104",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047140",
            "telephone_number": "541-779-1282",
            "fax_number": "541-608-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "201141590RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Saipani Eli, QMHA
• Margareth Eliacin
• Kiara Grace Elkin, PA-C
• Amilia Elliott, DPT
• Brenda Joel Elliott
• Rebecca Elizabeth Elliott, D.O.
• Amee Alene Ellis, OTL
• Wendy N Ellison, RD, RDN
• Rebecca Irene Elston
• Elysian Health

• Addiction (Substance Use Disorder) Registered Nurse in Medford, OR
• Providers in Medford, OR by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.