Active NPI
Mary Ellie Stankus, APRN, RN
- Nurse Practitioner
- Ansonia, CT
National Provider Identifier
1649222019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 002831
- Practice address
- 22 Westfield Ave
Ansonia, CT 06401-1158 - Phone
- (203) 736-9919
- Fax
- (855) 212-4728
- NPI assigned
- May 16, 2006
- Last updated
- Oct 10, 2018
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 002831 | CT | Primary |
Addresses
Primary practice location
22 Westfield Ave
Ansonia, CT 06401-1158
Mailing address
67 Derby Ave
Derby, CT 06418-1328
Phone (203) 732-1330
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004235596 | Medicaid | CT |
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, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002831 | CT | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539129600000",
"number": "1649222019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 DERBY AVE",
"city": "DERBY",
"state": "CT",
"postal_code": "064181328",
"telephone_number": "203-732-1330",
"fax_number": "203-732-1332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 WESTFIELD AVE",
"city": "ANSONIA",
"state": "CT",
"postal_code": "064011158",
"telephone_number": "203-736-9919",
"fax_number": "855-212-4728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STANKUS",
"first_name": "MARY ELLIE",
"name_prefix": "Mrs.",
"credential": "APRN, RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-16",
"last_updated": "2018-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CT",
"license": "002831",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004235596",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ansonia, CT
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- Roman Spivak, MD
- Matthew Paul Staniewicz, LMSW
- Ira J Stein, DDS
- Stephen Moses, M.D., LLC
- Jennifer L Stevens, LPC
- Patrick Stone, LPC
- Stop and Shop Supermarket Co LLC (Stop and Shop Pharmacy #635)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.