Individual provider Active NPI

A'Nis Ezell

  • Contractor
  • Cleveland, OH
National Provider Identifier
1689496739
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
2811 E 119TH St
Cleveland, OH 44120-2117
Phone
(440) 283-8652
NPI assigned
Oct 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X OH Primary

Addresses

Primary practice location

2811 E 119TH St
Cleveland, OH 44120-2117

Mailing address

2811 E 119TH St
Cleveland, OH 44120-2117
Phone (440) 283-8652

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": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1689496739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 E 119TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202117",
            "telephone_number": "440-283-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 E 119TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441202117",
            "telephone_number": "440-283-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZELL",
        "first_name": "A'NIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.