Tamara F Ellis, NURSE PRAACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11010826 Issued in FL

Practice address

163 Putnam County Blvd
East Palatka, FL 32131-6061

Phone

(386) 538-1285

NPI assigned

Aug 7, 2020

Last updated

Jun 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: tamara.ellis.1@14940.direct.athenahealth.com
• Direct secure messaging: tamara.ellis.1@30520.direct.athenahealth.com

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

{
    "created_epoch": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1699385344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 PUTNAM CO BLVD",
            "address_2": "P.O. BOX 362",
            "city": "EAST PALATKA",
            "state": "FL",
            "postal_code": "321314006",
            "telephone_number": "386-538-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 PUTNAM COUNTY BLVD",
            "city": "EAST PALATKA",
            "state": "FL",
            "postal_code": "321316061",
            "telephone_number": "386-538-1285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TAMARA",
        "middle_name": "F",
        "credential": "NURSE PRAACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2021-06-29",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11010826",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9233624",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Colombani, M.D.
• Michele Lorraine Davis
• Mariana Dejuk
• Katrina Ailene Dowden, NP-BC
• Eastgate Vision Center
• Extended Care Pharmacy East Inc
• Damaris Feliberty, MS
• Chelsea Riddle Fortner, OTR/L
• G.R.O.W.T.H. Counseling and Therapy, LLC
• Leslie Wayne Garrett, M.D.

• Family Nurse Practitioner in East Palatka, FL
• Providers in East Palatka, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.