Ellisjah Whaley

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

920 Medical Dr
Manila, AR 72442-8416

Phone

(870) 570-0358

Fax

(870) 570-0359

NPI assigned

Aug 4, 2025

Sex

Male

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)

Not enrolled

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.

• Delta Behavioral Health, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Manila, AR
  • NPI 1720637085
  NPD

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1861376642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 717",
            "city": "MANILA",
            "state": "AR",
            "postal_code": "724420717",
            "telephone_number": "870-570-0358",
            "fax_number": "870-570-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MEDICAL DR",
            "city": "MANILA",
            "state": "AR",
            "postal_code": "724428416",
            "telephone_number": "870-570-0358",
            "fax_number": "870-570-0359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "ELLISJAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aubrey Garrett Weaver, DPT
• Barbara A Weaver, LCSW
• Amanda Welch
• Wells Family Eyecare PA
• Letisha L West
• Alicia Dawn Whitlock, LMSW
• Bruce T Wilson, D.D.S.
• Kristy Lynn Wilson, APN
• Richard Brett Wortham, P.T.

• Case Manager/Care Coordinator in Manila, AR
• Providers in Manila, AR by specialty
• Case Manager/Care Coordinator in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2025; 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.