Individual provider Active NPI

Sonja Kristina Ellerbee, MSN, APRN, NP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1790362002
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1031344 Issued in TX
Practice address
3507 Valencia Peak
San Antonio, TX 78261-2408
Phone
(915) 588-6085
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1031344 TX Primary

Addresses

Primary practice location

3507 Valencia Peak
San Antonio, TX 78261-2408

Mailing address

3507 Valencia Peak
San Antonio, TX 78261-2408

Other identifiers 1

IdentifierTypeStateIssuer
1031344OtherTXTEXAS BON

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL n/a Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220322000144 OR Order and Referring Only - Nurse Practitioner 6204221658

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
1031344TXMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1790362002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 VALENCIA PEAK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782612408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 VALENCIA PEAK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782612408",
            "telephone_number": "915-588-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERBEE",
        "first_name": "SONJA",
        "middle_name": "KRISTINA",
        "credential": "MSN, APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1031344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BON",
            "identifier": "1031344",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "n/a",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "3507 Valencia Peak",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782612408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.