Ellyce Charles, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R15796 Issued in NM

Practice address

12 Twin Buttes Drive
Zuni, NM 87327

Phone

(505) 782-5511

NPI assigned

Nov 15, 2016

Last updated

Nov 15, 2016By the provider in NPPES

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

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Zuni Public School District

  • Local Education Agency (LEA)
  • Zuni, NM
  • NPI 1538296652
  NPD (past)

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1902348477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX A",
            "city": "ZUNI",
            "state": "NM",
            "postal_code": "873270166",
            "telephone_number": "505-870-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 TWIN BUTTES DRIVE",
            "city": "ZUNI",
            "state": "NM",
            "postal_code": "87327",
            "telephone_number": "505-782-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "ELLYCE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-15",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R15796",
            "primary": true
        },
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NM",
            "license": "230487",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demetri Blanas, MD
• Frank Bono, PHD
• Dominic Francis Caruso, M.D.
• Nadra Cavero, MD
• Levonia Esther Cellicion, RN
• Juana L Chavez
• Kyla Cheama, BA, LSAA
• Farlan Cooeyate, PA
• Eric Coontz, DDS DENTISTRY
• Johanna Karin Cooper, FNP

• Registered Nurse in Zuni, NM
• Providers in Zuni, NM by specialty
• Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; 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.