Active NPI
Nancy Ann Elliott, PH.D.
- Forensic Psychologist
- Sun Prairie, WI
National Provider Identifier
1568794469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- 2600-057
- Practice address
- 712 Lois Dr
Sun Prairie, WI 53590-1100 - Phone
- (608) 213-5474
- Fax
- (888) 643-9220
- NPI assigned
- Feb 3, 2010
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2600-057 | WI | |
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | 2600-057 | WI | |
| Clinical Psychologist | 103TC0700X | 2600-057 | WI | |
| Counseling Psychologist | 103TC1900X | 2600-057 | WI | |
| Forensic Psychologist | 103TF0200X | 2600-057 | WI | Primary |
Addresses
Primary practice location
712 Lois Dr
Sun Prairie, WI 53590-1100
Mailing address
712 Lois Dr
P.O. Box 146
Sun Prairie, WI 53590-1100
Phone (608) 213-5474
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2600-057 | WI | MD | Addiction (Substance Use Disorder) Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265155200000",
"number": "1568794469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 LOIS DR",
"address_2": "P.O. BOX 146",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535901100",
"telephone_number": "608-213-5474",
"fax_number": "888-643-9220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 LOIS DR",
"city": "SUN PRAIRIE",
"state": "WI",
"postal_code": "535901100",
"telephone_number": "608-213-5474",
"fax_number": "888-643-9220"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "NANCY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-03",
"last_updated": "2010-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "2600-057",
"primary": false
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": "WI",
"license": "2600-057",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WI",
"license": "2600-057",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "WI",
"license": "2600-057",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "WI",
"license": "2600-057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sun Prairie, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.