Tamika Clarice Ellis, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN-114184 Issued in OH

Practice address

5354 Ashford Ridge Rd
Westerville, OH 43081-6005

Phone

(419) 290-3824

NPI assigned

May 15, 2007

Last updated

Mar 10, 2008By the provider in NPPES

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 2

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1639385925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5354 ASHFORD RIDGE RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430816005",
            "telephone_number": "419-290-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 ASHFORD RIDGE RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430816005",
            "telephone_number": "419-290-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TAMIKA",
        "middle_name": "CLARICE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN-114184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT PROVIDER",
            "identifier": "2574790",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2574790",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Eller, LSW
• Katherine Colleen Elliot, FNP
• Natalie Elliott
• Cortney E Ellis, MSW LSW
• Jeffrey W Ellis, BA
• Victoria Elizabeth Ellis, MD
• Amy Lynn Ellsworth
• Audrey Elrod, RBT
• Brittany N Elson, COTA/L
• Ramachander Rao Eluri, M.D.,

• Licensed Practical Nurse in Westerville, OH
• Providers in Westerville, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; 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.