Active NPI
Natasha Antoinette Ellis, CPSS, CRC
- Specialist
- Canton, MI
National Provider Identifier
1891071700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 40075 Eaton St
202
Canton, MI 48187-4500 - Phone
- (734) 981-1442
- NPI assigned
- Oct 25, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | MI | Primary |
Addresses
Primary practice location
40075 Eaton St
202
Canton, MI 48187-4500
Mailing address
1465 Tamarind Ave 685
685
Los Angeles, CA 90028
Phone (734) 772-8640
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627430400000",
"number": "1891071700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 TAMARIND AVE 685",
"address_2": "685",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90028",
"telephone_number": "734-772-8640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40075 EATON ST",
"address_2": "202",
"city": "CANTON",
"state": "MI",
"postal_code": "481874500",
"telephone_number": "734-981-1442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "NATASHA",
"middle_name": "ANTOINETTE",
"name_prefix": "Ms.",
"credential": "CPSS, CRC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-25",
"last_updated": "2021-07-28",
"certification_date": "2021-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.