Tanace Ellis

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

12888 Issued in FL

Practice address

10100 Baymeadows Rd
Apt#1504
Jacksonville, FL 32256-0536

Phone

(904) 654-1499

NPI assigned

Jun 16, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1831570787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 BAYMEADOWS RD",
            "address_2": "APT#1504",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560536",
            "telephone_number": "904-654-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 BAYMEADOWS RD",
            "address_2": "APT#1504",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560536",
            "telephone_number": "904-654-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "TANACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CA",
            "license": "3042",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "12888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Page Ellis, MA, MSW
• Marlena Shandrell Ellis, FNP
• Michelle Ellis
• Nancy Ellis, RRT
• Steven Maurice Ellis II
• Troy Townsend Ellis, PA-C
• Robert G Ellison Jr., MD
• Eloisa Anne Ello-Esma, ARNP, FNP-BC
• Marylou V Ello, ARNP
• Joseph Ellow

• Occupational Therapy Assistant in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.