Active NPI
Stephanie Knight Ellis, R. PH.
- Oncology Pharmacist
- Canton, GA
National Provider Identifier
1497393268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oncology Pharmacist
- License
- 15726
- Practice address
- 450 Northside Cherokee Blvd
Canton, GA 30115-8015 - Phone
- (770) 221-9118
- NPI assigned
- Dec 12, 2019
- Last updated
- Dec 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oncology Pharmacist | 1835X0200X | 15726 | GA | Primary |
Addresses
Primary practice location
450 Northside Cherokee Blvd
Canton, GA 30115-8015
Mailing address
4668 Warrington Dr NE
Roswell, GA 30075-3183
Phone (229) 392-0087
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15726 | GA | MD | Oncology Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576108800000",
"number": "1497393268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4668 WARRINGTON DR NE",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300753183",
"telephone_number": "229-392-0087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 NORTHSIDE CHEROKEE BLVD",
"city": "CANTON",
"state": "GA",
"postal_code": "301158015",
"telephone_number": "770-221-9118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "STEPHANIE",
"middle_name": "KNIGHT",
"credential": "R. PH.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-12-12",
"last_updated": "2019-12-12",
"certification_date": "2019-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "1835X0200X",
"taxonomy_group": "",
"desc": "Pharmacist, Oncology",
"state": "GA",
"license": "15726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.