Ellis Nam, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

818207-01 Issued in NY

Practice address

5 Vineyard LN Apt 104
Newburgh, NY 12550

Phone

(661) 802-1896

NPI assigned

Oct 4, 2021

Last updated

Oct 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1386316818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 VINEYARD LN APT 104",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125507064",
            "telephone_number": "661-802-1896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 VINEYARD LN APT 104",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "12550",
            "telephone_number": "661-802-1896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAM",
        "first_name": "ELLIS",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "818207-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sateesh Mypati
• Sam Hyun-Ju NA, DDS
• Laith Anton Naayem, L.AC.
• Khadija Naeem
• Aiswarya Nair, MBBS
• Sangmi Nam, L.AC.
• Shellene Napier, FNP
• Hassan Naqvi
• Kelly Anne Narvaez
• Syed Nasir, MD

• Registered Nurse in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.