Michaela Jean Ennis

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

721390 Issued in NY

Practice address

38 Seneca St
Baldwinsville, NY 13027-2809

Phone

(315) 558-0976

NPI assigned

Oct 3, 2019

Last updated

Oct 3, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1922649680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 SENECA ST",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130272809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 SENECA ST",
            "city": "BALDWINSVILLE",
            "state": "NY",
            "postal_code": "130272809",
            "telephone_number": "315-558-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "MICHAELA",
        "middle_name": "JEAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "721390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rona Edlund
• Cathleen Egan
• Moira Eilers, LCSW
• Joan Sharon Ellsworth, COTA
• Asad Emi
• Valerie Marie Erwin
• Charissa Evans
• Rebecca Everitt, R.N.
• Pamela Faba-Springs
• Doreen Faber, LCSW-R

• Pediatric Registered Nurse in Baldwinsville, NY
• Providers in Baldwinsville, NY by specialty
• Pediatric Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.