Adrienne Michele Ellis

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

064514 Issued in NC

Practice address

1130 Midland Ter
Durham, NC 27704-5140

Phone

(919) 236-7507

NPI assigned

Feb 17, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1518289685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 MIDLAND TER",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277045140",
            "telephone_number": "919-236-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 MIDLAND TER",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277045140",
            "telephone_number": "919-236-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ADRIENNE",
        "middle_name": "MICHELE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NC",
            "license": "064514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "064514",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy F. Elliott, LPC
• David Michael Elliott, MD, PHD
• Richard Ryland Elliott, CRNA
• Scotty A Elliott, LCSW
• Ellis K. List, D.D.S., P.a.
• Caryn Ellis, OT
• Emily Dickson Ellis
• Kayley Ellis
• Mary Claire Ellis, MD, MPH
• Matthew J. Ellis, M.D.

• Licensed Practical Nurse in Durham, NC
• Providers in Durham, NC by specialty
• Licensed Practical Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.