Jessica Erin Ellis, R.N.

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN189320 Issued in GA

Practice address

500 Bethany Woods Dr
Temple, GA 30179-3574

Phone

(205) 902-4928

NPI assigned

Feb 1, 2008

Last updated

Feb 1, 2008By 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 2

Addresses

Other names 1

• Miss Jessica Erin Ellis Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1356529358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 PELHAM ST",
            "city": "CHICKASAW",
            "state": "AL",
            "postal_code": "366112410",
            "telephone_number": "205-902-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 BETHANY WOODS DR",
            "city": "TEMPLE",
            "state": "GA",
            "postal_code": "301793574",
            "telephone_number": "205-902-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JESSICA",
        "middle_name": "ERIN",
        "name_prefix": "Miss",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-01",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN189320",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-107940",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ELLIS",
            "middle_name": "ERIN",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lauren Michelle Cavender, CPHT
• Michelle Chewning, R.PH.
• Duane Edward Cox, D.M.D.
• Walter Allen Culpepper, D. C.
• Diversified Medical Clinic, LLC
• Darlene Evans
• Aaisha D Flint, RN
• Ginger L Fordham
• Thomas Jackson Fowler II, PHARM.D.
• Kimberly Monique Fryer, MSN, AGNP-C

• Registered Nurse in Temple, GA
• Providers in Temple, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; 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.