Samantha Ellis, DNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP8278 Issued in AZ

Practice address

15420 N 32ND Dr
Phoenix, AZ 85053

Phone

(602) 866-1974

NPI assigned

May 24, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

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.

• Arbor Medical Partners, LLC

  • Pediatrics Physician
  • Scottsdale, AZ
  • NPI 1023546082
  NPD (past)
• North Scottsdale Pediatric Associates

  • Pediatrics Physician
  • Scottsdale, AZ
  • NPI 1275797235
  NPD (past)
• Northwest Cloinic for Children

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1083815666
  NPD (past)

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1356799985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15420 N 32ND DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85053",
            "telephone_number": "602-866-1974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Blythe Blvd",
            "address_2": "Medical Center Plaza Suite 601",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035866",
            "country_code": "US",
            "telephone_number": "704-381-9900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SAMANTHA",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "AP8278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387005",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Ellis
• Martha A Ellis, PA-C
• Maya Ellis
• Michelle Jeanette Ellis, LMFT
• Nora Denise Ellis, PAC
• Stephanie Ellis, CRNP
• Lauren Ellish, CCC-SLP
• Jeanette Leann Ellison, PMHNP-C
• Kimberlee Janette Despain Ellison, PT, DPT, C/NDT
• Sarah Ells

• All providers in Phoenix, AZ
• Pediatric Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.