Amanda Lynn Ellis, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP0036119 Issued in OH

Practice address

3893 E Market St
Warren, OH 44484-4706

Phone

(330) 856-4000

NPI assigned

Mar 25, 2024

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

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Warren Otologic Group, Inc

  • Otolaryngology Physician
  • Warren, OH
  • NPI 1720023351
  Medicare reassignment NPD

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1821848524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 RUSSELL AVE",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445152020",
            "telephone_number": "330-881-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3893 E MARKET ST",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444844706",
            "telephone_number": "330-856-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP0036119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zeina Geryes El Amil, MD
• Najah Elam
• Elite Harmony Healthcare
• Ellie House Inc
• Kathryn S Elliott I, RN,BSN
• Sierra Ellis, CT
• Summer Angel Ellis
• Felicia Elanie Ellison
• Sami Sid Ahmed Elsayed, M.D.
• Bree Danielle Elzy, L.P.N.

• Family Nurse Practitioner in Warren, OH
• Providers in Warren, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.