Active NPI
Amy Leigh Ellis, CPHT
- Pharmacy Technician
- Clarksville, TN
National Provider Identifier
1831242882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 17836
- Practice address
- 1051 S Riverside Dr
Clarksville, TN 37040-4303 - Phone
- (931) 645-2494
- NPI assigned
- Jan 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 17836 | TN | Primary |
Addresses
Primary practice location
1051 S Riverside Dr
Clarksville, TN 37040-4303
Mailing address
119 Shelton St
Clarksville, TN 37040-4053
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17836 | TN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831242882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 SHELTON ST",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370404053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1051 S RIVERSIDE DR",
"city": "CLARKSVILLE",
"state": "TN",
"postal_code": "370404303",
"telephone_number": "931-645-2494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "AMY",
"middle_name": "LEIGH",
"credential": "CPHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "TN",
"license": "17836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.