Lisa Ann Ellis

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

243616-01 Issued in NY

Practice address

42 Corley Dr
Rochester, NY 14622-1242

Phone

(585) 324-5915

NPI assigned

Sep 18, 2025

Sex

Female

Sole proprietor

No

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": "1758153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1932071230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 CORLEY DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146221242",
            "telephone_number": "585-324-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 CORLEY DR",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146221242",
            "telephone_number": "585-324-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "LISA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "243616-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Ellis, DPT
• Jennifer Lynn Ellis, M.D.
• Josephine Ellis, MD
• Kimberly Anne Ellis, R.N.
• Lashya Ellis, RN
• Rebecca Disson Ellis, MD
• Andrew Ellison, PA
• Devyn Rochelle Ellison, NP
• Lisa M Ellison, PT
• Nicole Ellison

• Licensed Practical Nurse in Rochester, NY
• Providers in Rochester, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.