Thomas W Ellsmore

Primary specialty

Gerontological Nutrition Registered DietitianTaxonomy code 133VN1101X

Practice address

50 S Meridian Rd
Youngstown, OH 44509-2638

Phone

(704) 796-6455

NPI assigned

Jul 26, 2022

Last updated

Jul 26, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kitchenabz LLC

  dba Kitchen Abz

  • Home Delivered Meals
  • Youngstown, OH
  • NPI 1861129504
  NPD Authorized official

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

{
    "created_epoch": "1658793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1902532526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S MERIDIAN RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445092638",
            "telephone_number": "704-796-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S MERIDIAN RD",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445092638",
            "telephone_number": "704-796-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSMORE",
        "first_name": "THOMAS",
        "middle_name": "W",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-26",
        "last_updated": "2022-07-26",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1101X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Gerontological",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0497130",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tom@kitchenabz.com",
            "affiliation": "N",
            "address_1": "50 S Meridian Rd",
            "city": "Youngstown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "445092638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kaitlynn Elizabeth Ellis
• Shannon Ellis
• Tawana Lakeisha Ellis
• Trey Carter Ellis
• Syledah Cairi Ellison
• Stacey D Elser
• Chantal Marie Elza, RN
• April Dawn Emanuel
• Emerge Counseling & Coaching, LLC
• Emerge Counseling & Coaching, LLC

• Registered Dietitian in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Registered Dietitian in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.