Active NPI
Amanda Ellingsen
- Marriage & Family Therapist
- Nashville, TN
National Provider Identifier
1982267308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1266
- Practice address
- 600 12TH Ave S Apt 522
Nashville, TN 37203-6619 - Phone
- (760) 579-2303
- NPI assigned
- Apr 22, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1266 | TN | Primary |
Addresses
Primary practice location
600 12TH Ave S Apt 522
Nashville, TN 37203-6619
Mailing address
600 12TH Ave S Apt 522
Nashville, TN 37203-6619
Phone (760) 579-2303
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Nashville |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1266 | TN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555891200000",
"number": "1982267308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 12TH AVE S APT 522",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372036619",
"telephone_number": "760-579-2303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 12TH AVE S APT 522",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372036619",
"telephone_number": "760-579-2303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLINGSEN",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-22",
"last_updated": "2019-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TN",
"license": "1266",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Nashville",
"affiliation": "N",
"address_1": "600 12th Ave S Apt 522",
"city": "Nashville",
"state": "TN",
"country_code": "US",
"postal_code": "372036619",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.