Bethany Ellis, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

305866 Issued in NY

Practice address

14 Franklin St
Westfield, NY 14787-1009

Phone

(716) 224-3521

NPI assigned

Jun 27, 2018

Last updated

Jun 27, 2018By 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

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": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1649765108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FRANKLIN ST",
            "city": "WESTFIELD",
            "state": "NY",
            "postal_code": "147871009",
            "telephone_number": "716-224-3521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 FRANKLIN ST",
            "city": "WESTFIELD",
            "state": "NY",
            "postal_code": "147871009",
            "telephone_number": "716-224-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "BETHANY",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "305866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CVS Albany, L.L.C. (CVS Pharmacy #05075)
• Kaitlyn Mackenzie Dahl
• Jacob Tyler Damcott, DPT
• Ruth Ann Reed Dougan, RN
• Gary Eugene Eggleston, MD
• Russell S Elwell, M.D.
• Phyllis Elaine Firth - Gutz, LMT
• Sara M Foote, RDN
• Kathryn Freeman, LMSW
• Katelyn Frye, RN

• Licensed Practical Nurse in Westfield, NY
• Providers in Westfield, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.

Verify at the official NPI Registry.