Individual provider Active NPI

Ellen B Barton, ANP

  • Adult Health Nurse Practitioner
  • Berwyn, IL
National Provider Identifier
1336367036
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209003213 Issued in IL
Practice address
6201 Roosevelt Rd
Berwyn, IL 60402-1108
Phone
(708) 386-0845
Fax
(708) 386-8472
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209003213 IL Primary

Addresses

Primary practice location

6201 Roosevelt Rd
Berwyn, IL 60402-1108

Mailing address

6201 Roosevelt Rd
Berwyn, IL 60402-1108
Phone (708) 386-0845

Other identifiers 1

IdentifierTypeStateIssuer
209003213MedicaidIL

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

State licenses

LicenseStateTypeSpecialty
209003213ILMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318896000000",
    "number": "1336367036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 ROOSEVELT RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604021108",
            "telephone_number": "708-386-0845",
            "fax_number": "708-386-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 ROOSEVELT RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604021108",
            "telephone_number": "708-386-0845",
            "fax_number": "708-386-8472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTON",
        "first_name": "ELLEN",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2011-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209003213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209003213",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.