Paige Ellefson

Primary specialty

Other TechnicianTaxonomy code 247200000X

Practice address

1011 Meadowlands Dr Ste 1&2
White Bear Lake, MN 55127-2339

Phone

(612) 315-1976

NPI assigned

Jan 25, 2021

Last updated

Jan 25, 2021By 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

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1689264582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 INDUSTRIAL DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559010700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 MEADOWLANDS DR STE 1&2",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551272339",
            "telephone_number": "612-315-1976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "731 Bielenberg Dr Ste 102-104",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551251700",
            "country_code": "US",
            "telephone_number": "612-445-8324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLEFSON",
        "first_name": "PAIGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "",
            "desc": "Technician, Other",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Other Technician in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Other Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.