Pamela Ellis, M.A. CCC-SP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA12538 Issued in FL

Practice address

2175 Seminole Shores LN
Vero Beach, FL 32963-3126

Phone

(260) 413-8825

NPI assigned

Jun 7, 2014

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

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402099200000",
    "number": "1669885604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 SEMINOLE SHORES LN",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329633126",
            "telephone_number": "260-413-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 SEMINOLE SHORES LN",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329633126",
            "telephone_number": "260-413-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "PAMELA",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-07",
        "last_updated": "2014-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA12538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Physical Therapy of Vero Beach LLC
• Dathy-Andele Elize Toussaint
• Ellen T Melvin MD PA
• Anna Jones Elliott, CCC-SLP
• Connie Elliott, RN
• Anna Kathryn Ellison
• Tiffany Jill Ellison
• Hazem Eluri, PHARMD
• Frank Elwin, M.D.
• Khaldoun Elzoobi, MD

• Speech-Language Pathologist in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.

Verify at the official NPI Registry.