Peggy Ellis

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

054862 Issued in MO

Practice address

1993 Wentzville Pkwy
Wentzville, MO 63385-3424

Phone

(866) 825-3227

NPI assigned

Oct 30, 2009

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Take Care Health Missouri, PC

  • Family Nurse Practitioner
  • Kansas City, MO
  • NPI 1285601443
  NPD (past)

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256860800000",
    "number": "1821324591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 WASHINGTON ST",
            "address_2": "EIGHT TOWER BRIDGE SUITE 1400",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1993 WENTZVILLE PKWY",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853424",
            "telephone_number": "866-825-3227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "PEGGY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-30",
        "last_updated": "2009-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "054862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Lee Edwards, NP-C
• Pappa Umonoibalo Ehimare, MD
• Erica Elder, PHARMD
• Elevate Care Providers LLC
• Jeffery William Ellis, RPH
• Gary Ellul, LPC
• Lindsey Shaynae Elms
• Emergency Medical Care LLC
• John E Emmons, DO
• Christina Eschenbrener

• Family Nurse Practitioner in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.