Individual provider Active NPI

Elizabeth Ann Ellison

  • Pharmacist
  • Horseheads, NY
National Provider Identifier
1760115349
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
068394 Issued in NY
Practice address
2887 Westinghouse Rd
Horseheads, NY 14845-8110
Phone
(607) 796-2193
NPI assigned
Jul 1, 2022
Last updated
Jul 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 068394 NY Primary

Addresses

Primary practice location

2887 Westinghouse Rd
Horseheads, NY 14845-8110

Mailing address

1073 Sing Sing Rd Apt B5
Horseheads, NY 14845-1391
Phone (607) 427-6835

Other practice location 1

215 Hoffman St
Elmira, NY 14905-2423
Phone (607) 732-0597

Other practice location 2

98 W Pulteney St
Corning, NY 14830-2260
Phone (607) 936-3233

Other practice location 3

130 S Main St
Elmira, NY 14904-1309
Phone (607) 733-6696

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

State licenses

LicenseStateTypeSpecialty
068394NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gerould's Professional Pharmacy Inc. PastSince Jul 17, 2022 Accepting new patients
Geroulds Professional Pharmacy Inc Past Accepting new patients
Gerould's Professional Pharmacy Inc. PastSince Jul 17, 2022 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1656633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1760115349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1073 SING SING RD APT B5",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148451391",
            "telephone_number": "607-427-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2887 WESTINGHOUSE RD",
            "city": "HORSEHEADS",
            "state": "NY",
            "postal_code": "148458110",
            "telephone_number": "607-796-2193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Hoffman St",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149052423",
            "country_code": "US",
            "telephone_number": "607-732-0597",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "98 W Pulteney St",
            "address_purpose": "LOCATION",
            "city": "Corning",
            "state": "NY",
            "postal_code": "148302260",
            "country_code": "US",
            "telephone_number": "607-936-3233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 S Main St",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149041309",
            "country_code": "US",
            "telephone_number": "607-733-6696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-01",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "068394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horseheads, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.