Danny Ellis, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R826981 Issued in MS

Practice address

2100 Highway 61 N
Vicksburg, MS 39183-8211

Phone

(601) 883-4250

NPI assigned

May 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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

• Claiborne County Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Port Gibson, MS
  • NPI 1710238324
  NPD
• Family Wellness Clinic LLC

  • Family Medicine Physician
  • Port Gibson, MS
  • NPI 1457544066
  NPD (past)
• Medical Associates of Vicksburg PLLC

  • Internal Medicine Physician
  • Vicksburg, MS
  • NPI 1508278177
  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1760699540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-883-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 HIGHWAY 61 N",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391838211",
            "telephone_number": "601-883-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "DANNY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R826981",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "R826981",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00634567",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029611",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edward Brown Specialty Partners of Mississippi, PLLC
• Natalie Edwards
• Terriaunce Edwards
• Kimberly Lynn Eldridge, MSN, FNP-BC, CWCN
• Elite Performance and Rehab, LLC
• Kaitlyn Ellis, D.M.D.
• Michael Barry Ellis, D.M.D.,P.A.
• Angela Kelley Elllis
• Margaret Ellzey-Nichols, D.M.D
• Sharon Elverton, PCMHT

• Nurse Practitioner in Vicksburg, MS
• Providers in Vicksburg, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.