Lynne M. Ellis, MD,PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

46897 Issued in FL

Legal business name

LYNNE M. ELLIS, MD,PA

Practice address

1111 7TH Ave N Ste 103
St Petersburg, FL 33705-1348

Phone

(727) 822-5393

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Lynne M Ellis, MD

Title

President

Phone

(727) 822-5393

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348531200000",
    "number": "1912056540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 7TH AVE N STE 103",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 7TH AVE N STE 103",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051348",
            "telephone_number": "727-822-5393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNNE M. ELLIS, MD,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2012-09-25",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-822-5393",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "46897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262210600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William T Lyne, LICSW
• Chiquita Kawanda Lynn-Walker, ARNP
• Brandon Keith Lynn, APRN, CPNP-AC
• Breasia Z Lynn
• Kaitlyn Asa Lynn, APRN
• Elisa Margo Lynskey, M.D.
• Lyons Anesthesia Servies
• Joseph Lyons
• Kelly Marie Lyons, CRNA
• M & J Home Care

• Primary Care Clinic/Center in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; 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.