Johanna Ellis, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704296749 Issued in MI

Practice address

4646 John R St
Detroit, MI 48201-1916

Phone

(313) 576-1000

NPI assigned

Dec 8, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1770446619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47700 FREEDOM VALLEY DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480442567",
            "telephone_number": "313-576-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011916",
            "telephone_number": "313-576-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JOHANNA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704296749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Ross Elliott, LMSW, CAADC, CCS
• Torri Elliott, LMSW
• Ellis Care Services Inc.
• Charmine Ellis, B.S. CACM
• Deborah A Ellis, PHD
• Karishma Sohil Ellis, DO
• Kiya Ellis
• Niaah Ellis, B.A.H.C.S.
• Patricia Ann Ellis
• Sandra Caprece Ellis

• Registered Nurse in Detroit, MI
• Providers in Detroit, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.