Individual provider Active NPI

Julie E Ellison

  • School Registered Nurse
  • Peoria, AZ
National Provider Identifier
1962682070
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
RN138936 Issued in AZ
Practice address
26716 N High Desert Dr
Peoria, AZ 85383-3673
Phone
(623) 376-5010
Fax
(623) 376-5080
NPI assigned
Nov 6, 2007
Last updated
Nov 6, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN138936 AZ Primary

Addresses

Primary practice location

26716 N High Desert Dr
Peoria, AZ 85383-3673

Mailing address

26716 N High Desert Dr
Peoria, AZ 85383-3673
Phone (623) 376-5010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN138936AZMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1962682070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26716 N HIGH DESERT DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833673",
            "telephone_number": "623-376-5010",
            "fax_number": "623-376-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26716 N HIGH DESERT DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853833673",
            "telephone_number": "623-376-5010",
            "fax_number": "623-376-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "JULIE",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "AZ",
            "license": "RN138936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.