Dan Ellis GNP Inc

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R826981 Issued in MS

Legal business name

DAN ELLIS GNP INC

Practice address

703B Farmer St
Port Gibson, MS 39150-2319

Phone

(601) 529-2871

Fax

(601) 629-9969

NPI assigned

Oct 4, 2012

Last updated

Dec 26, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dan Ellis

Title

President

Phone

(601) 636-0097

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356480000000",
    "number": "1942552732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 215",
            "city": "UTICA",
            "state": "MS",
            "postal_code": "391750215",
            "telephone_number": "601-529-2871",
            "fax_number": "601-629-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703B FARMER ST",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502319",
            "telephone_number": "601-529-2871",
            "fax_number": "601-629-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAN ELLIS GNP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-04",
        "last_updated": "2012-12-26",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-636-0097"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MS",
            "license": "R826981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Nurse Practitioner in Port Gibson, MS
• Providers in Port Gibson, MS by specialty
• Gerontology Nurse Practitioner in Mississippi

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