Individual provider Active NPI

Maria Ellis

  • Lactation Consultant (Registered Nurse)
  • Chapel Hill, NC
National Provider Identifier
1770105397
Registry record updated May 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
L-134569 Issued in NC
Practice address
930 Martin Luther King Jr Blvd Ste 202
Chapel Hill, NC 27514-2656
Phone
(919) 933-3301
Fax
(919) 933-3375
NPI assigned
May 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X L-134569 NC Primary

Addresses

Primary practice location

930 Martin Luther King Jr Blvd Ste 202
Chapel Hill, NC 27514-2656

Mailing address

930 Martin Luther King Jr Blvd Ste 202
Chapel Hill, NC 27514-2656
Phone (919) 933-3301

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL AMDEHR Health Information Exchange (HIE)

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
L-134569NCMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1770105397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 MARTIN LUTHER KING JR BLVD STE 202",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142656",
            "telephone_number": "919-933-3301",
            "fax_number": "919-933-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 MARTIN LUTHER KING JR BLVD STE 202",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142656",
            "telephone_number": "919-933-3301",
            "fax_number": "919-933-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NC",
            "license": "L-134569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "AMDEHR",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "electronic health record",
            "address_1": "930 Martin Luther King Jr Blvd Ste 202",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275142656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.