Jennifer Ellis, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95008657 Issued in CA

Practice address

16101 Ventura Blvd Ste 330
Encino, CA 91436-2516

Phone

(702) 703-6763

NPI assigned

Mar 17, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Progressive Wellness & Aesthetics, LLC

  • Family Nurse Practitioner
  • Las Vegas, NV
  • NPI 1255268132
  NPD Authorized official
• Ara Keshishian, a Professional Medical Corp

  • Medical Specialty Clinic/Center
  • Pasadena, CA
  • NPI 1518127968
  NPD (past)
• Christy Anthony MD Inc

  • Pain Medicine (Anesthesiology) Physician
  • Glendale, CA
  • NPI 1801556808
  NPD (past)

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

{
    "created_epoch": "1521244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1487157277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16101 VENTURA BLVD STE 330",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362516",
            "telephone_number": "702-703-6763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16101 VENTURA BLVD STE 330",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914362516",
            "telephone_number": "702-703-6763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4275 Burnham Ave Ste 325A",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891198212",
            "country_code": "US",
            "telephone_number": "702-703-6763",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-17",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "866856",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95008657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elliot Ryan Carlisle MD Inc
• Dennis Elliott Jr., DACM, L.AC.
• Gina Elliott, M.A. CCC-SLP
• Dock Phillip Ellis III
• Hsiao Chien Ellis, L.AC.
• Omar Harbey Eloustaz, DDS
• Gregory Elsky, PSY. D
• Elviga Home Health Inc
• Farnood Elyasian
• Sina Emami, MD

• Family Nurse Practitioner in Encino, CA
• Providers in Encino, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.