Active NPI
Lori Lee Ellett, FNP-C
- Family Nurse Practitioner
- Herrin, IL
National Provider Identifier
1538406038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209010037
- Practice address
- 3314 Patriot CT
Herrin, IL 62948 - Phone
- (618) 993-0056
- Fax
- (618) 993-0752
- NPI assigned
- Jan 3, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209010037 | IL | Primary |
Addresses
Primary practice location
3314 Patriot CT
Herrin, IL 62948
Mailing address
PO Box 1105
Indianapolis, IN 46206-1105
Phone (618) 549-5361
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1538406038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1105",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462061105",
"telephone_number": "618-549-5361",
"fax_number": "618-529-0568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3314 PATRIOT CT",
"city": "HERRIN",
"state": "IL",
"postal_code": "62948",
"telephone_number": "618-993-0056",
"fax_number": "618-993-0752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLETT",
"first_name": "LORI",
"middle_name": "LEE",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-03",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209010037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Herrin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.