Active NPI
Samantha A Ellis, PHARM.D, RPH
- Pharmacist
- Worcester, MA
National Provider Identifier
1578962437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH235432
- Practice address
- 320 Park Ave
Worcester, MA 01610-1021 - Phone
- (508) 767-1732
- NPI assigned
- Aug 17, 2014
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH235432 | MA | Primary |
Addresses
Primary practice location
320 Park Ave
Worcester, MA 01610-1021
Mailing address
320 Park Ave
Worcester, MA 01610-1021
Phone (508) 767-1732
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 Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH235432 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408233600000",
"number": "1578962437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 PARK AVE",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016101021",
"telephone_number": "508-767-1732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 PARK AVE",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016101021",
"telephone_number": "508-767-1732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "SAMANTHA",
"middle_name": "A",
"credential": "PHARM.D, RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-17",
"last_updated": "2014-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH235432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.