Active NPI
Jennifer Ellis
- Adult Day Care Clinic/Center
- Harrisonville, MO
National Provider Identifier
1609286194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- License
- 1174
- Practice address
- 208 Oriole St.
Harrisonville, MO 64701-0000 - Phone
- (816) 887-2010
- NPI assigned
- May 6, 2014
- 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 |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | 1174 | MO | Primary |
Addresses
Primary practice location
208 Oriole St.
Harrisonville, MO 64701-0000
Mailing address
208 Oriole St.
Harrisonville, MO 64701-0000
Phone (816) 887-2010
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1174 | MO | MD | Adult Day Care Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399334400000",
"number": "1609286194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 ORIOLE ST.",
"city": "HARRISONVILLE",
"state": "MO",
"postal_code": "647010000",
"telephone_number": "816-887-2010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "208 ORIOLE ST.",
"city": "HARRISONVILLE",
"state": "MO",
"postal_code": "647010000",
"telephone_number": "816-887-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-06",
"last_updated": "2014-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": "MO",
"license": "1174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harrisonville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.