Active NPI
Angela M Ellis
- Peer Specialist
- Grants Pass, OR
National Provider Identifier
1669124129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 1545 Harbeck Rd
Grants Pass, OR 97527-5605 - Phone
- (541) 476-2373
- NPI assigned
- Jan 25, 2022
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
1545 Harbeck Rd
Grants Pass, OR 97527-5605
Mailing address
1215 SW G St
Grants Pass, OR 97526-2544
Phone (541) 476-2373
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781049600000",
"number": "1669124129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1215 SW G ST",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975262544",
"telephone_number": "541-476-2373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1545 HARBECK RD",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275605",
"telephone_number": "541-476-2373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "ANGELA",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-25",
"last_updated": "2026-06-10",
"certification_date": "2026-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.