Active NPI
Jennifer Ellerbe, R.N.,B.S.N.
- Registered Nurse
- Kannapolis, NC
National Provider Identifier
1861595670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 148287
- Practice address
- 1305 S Cannon Blvd
Kannapolis, NC 28083-6232 - Phone
- (704) 939-1100
- Fax
- (704) 939-1173
- NPI assigned
- Sep 7, 2006
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 148287 | NC | Primary |
Addresses
Primary practice location
1305 S Cannon Blvd
Kannapolis, NC 28083-6232
Mailing address
2417 Emstead CT
Charlotte, NC 28210-7668
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
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 148287 | NC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861595670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2417 EMSTEAD CT",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282107668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 S CANNON BLVD",
"city": "KANNAPOLIS",
"state": "NC",
"postal_code": "280836232",
"telephone_number": "704-939-1100",
"fax_number": "704-939-1173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLERBE",
"first_name": "JENNIFER",
"credential": "R.N.,B.S.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "148287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kannapolis, NC
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.