Devon Simone Ellena, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

7290 Issued in MN

Practice address

14655 Galaxie Ave
Apple Valley, MN 55124-8602

Phone

(952) 432-6161

Fax

(952) 891-3921

NPI assigned

Mar 4, 2020

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

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Allina Health System

  dba Allina Health Annandale Clinic

  • Family Medicine Physician
  • Annandale, MN
  • NPI 1457657249
  Medicare reassignment NPD
• Ellena Wellness

  • Primary Care Nurse Practitioner
  • Minneapolis, MN
  • NPI 1780511659
  NPD Authorized official
• Allina Health System

  dba Allina Health Buffalo Specialty Clinic

  • Obstetrics & Gynecology Physician
  • Buffalo, MN
  • NPI 1295272342
  NPD

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1467087064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14655 GALAXIE AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248602",
            "telephone_number": "952-432-6161",
            "fax_number": "952-891-3921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5329 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554171719",
            "country_code": "US",
            "telephone_number": "262-719-6184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLENA",
        "first_name": "DEVON",
        "middle_name": "SIMONE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "7290",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MN",
            "license": "7290",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Eckert
• Ecumen
• Ecumen (Ecumen Seasons at Apple Valley)
• Elite Dental, LLC
• Ellen Weis Chiropractic LLC
• Elleny Family Adult Care Corporation
• Victoria Joy Ellingson
• Fartun Hassan Elmi
• Elmwood Health Services
• Carol Susan Elstad, LPCC

• Adult Health Nurse Practitioner in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Adult Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.