SAMANTHA ELLIS (NPI# 1356799985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356799985 |
| Entity Type | Individual |
| Full Name | SAMANTHA ELLIS |
| Credential | DNP |
| Practice Address |
15420 N 32nd Dr Phoenix AZ 85053 |
| Mailing Address |
Po Box 19305 Charlotte NC 28219-9305 |
| Practice Telephone | 6028661974 |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2019-08-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP8278 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 387005 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1001 Blythe Blvd, Medical Center Plaza Suite 601, Charlotte, NC 282035866 | 7043819900 | |
| 1001 Blythe Blvd, Medical Center Plaza, Suite 200, Charlotte, NC 282035866 | 7043818840 | |
| 100 Medical Park Dr, Suite 310, Concord, NC 280252948 | 7044032660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841652567 | Samantha Michelle Ellis | Social Worker | 11097 Se 21st Ave, Milwaukie, OR 97222-7640 | 2016-03-22 |
| 1174918098 | Samantha Rose Ellis | Dermatology | 600 San Ramon Valley Blvd Ste 102, Danville, CA 94526-4021 | 2015-03-30 |
| 1811417736 | Samantha Ellis | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375 | 2017-06-21 |
| 1710341391 | Samantha Ellis | Nutritionist | 8915 Sw Center St, Tigard, OR 97223-6307 | 2016-04-08 |
| 1861861429 | Samantha Ellis | Counselor | 487 Center St, Manchester, CT 06040-3982 | 2015-09-24 |
| 1578962437 | Samantha A Ellis | Pharmacist | 320 Park Ave, Worcester, MA 01610-1021 | 2014-08-17 |
| 1285044750 | Samantha Ellis | Dietitian, Registered | 44 Pleasant Ave, Walden, NY 12586-1240 | 2014-05-05 |
| 1164726063 | Samantha Lee Ellis | Registered Nurse | 6200 Sw 73rd St, South Miami, FL 33143-4679 | 2011-01-06 |
| Street Address |
15420 N 32ND DR |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225092273 | Carl Franklin Irwin Sr. | Pediatrics | 15420 N 32nd Dr, Phoenix, AZ 85053-3927 | 2006-04-14 |
| 1083815666 | Northwest Cloinic for Children | Pediatrics | 15420 N 32nd Dr, Phoenix, AZ 85053-3927 | 2007-05-30 |
| 1811056971 | Sylvia Matherly | Nurse Practitioner | 15420 N 32nd Dr, Phoenix, AZ 85053-3927 | 2006-12-06 |
| 1710046719 | Stacey Anne Toben | Nurse Practitioner | 15420 N 32nd Dr, Phoenix, AZ 85053-3927 | 2006-12-06 |
| 1134287683 | Katharine L Dessenberger | Nurse Practitioner | 15420 N 32nd Dr, Phoenix, AZ 85053-3927 | 2006-12-05 |
| 1801954342 | Devra W. Spindler | Nurse Practitioner | 15420 N 32nd Dr, Phoenix, AZ 85053-3927 | 2006-12-05 |
| 1346205721 | Karen Leslie Kennedy | Pediatrics | 15420 N 32nd Dr, Phoenix, AZ 85053-3927 | 2006-04-19 |
| 1528023850 | Kristin Kaye Kaus | Pediatrics | 15420 N 32nd Dr, Phoenix, AZ 85053-3927 | 2006-04-19 |
| 1922063288 | Pamela Clark Bingham | Pediatrics | 15420 N 32nd Dr, Phoenix, AZ 85053-3927 | 2006-04-19 |
| 1275598047 | David Allen Galles | Pediatrics | 15420 N 32nd Dr, Phoenix, AZ 85053-3927 | 2006-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871065615 | Valley Addiction & Mental Health Services LLC | Nurse Practitioner | 16845 N. 29th Ave, Ste 1-211, Phoenix, AZ 85053 | 2018-12-18 |
| 1417439100 | Amanda M Sherwin | Dietitian, Registered | 15640 N 28h Drive, Phoenix, AZ 85053 | 2018-08-30 |
| 1568970135 | Sage Counseling, Inc. | Community/Behavioral Health | 2734 W Bell Rd., #1385 & 1390, Phoenix, AZ 85053 | 2018-01-17 |
| 1366966434 | Penny L Reamer | Registered Nurse | 17624 N. 31st Ave., Phoenix, AZ 85053 | 2017-08-01 |
| 1043749302 | Jacob Stephen Lawrence | Occupational Therapy Assistant | 3116 W. Hartford Dr., Phoenix, AZ 85053 | 2017-06-08 |
| 1770022923 | Horizon Dental Group West Valley | Dentist | 4025 W. Bell Road, Suite 20, Phoenix, AZ 85053 | 2017-02-21 |
| 1235594938 | Linda Thi Trinh | Optometrist | 16020 North 35th Ave Suite #2, Phoenix, AZ 85053 | 2015-12-22 |
| 1003230301 | Continuum Group West, LLC. | Clinic/Center | 3710 W Greenway Rd, Suite 104, Phoenix, AZ 85053 | 2014-02-07 |
| 1831539410 | Michelle Lea Byers | Nurse Practitioner | 17624 North 31st Ave, Phoenix, AZ 85053 | 2013-06-27 |
| 1437446580 | Candace Faith Gershkovich | Dentist | 4235 W. Thunderbird Rd, Phoenix, AZ 85053 | 2011-07-08 |
| Find all providers in zip 85053 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083258354 | Stephenie Ann Lechuga | Nurse Practitioner | 3415 W Glendale Ave Ste 32a, Phoenix, AZ 85051-8485 | 2019-10-30 |
| 1215455605 | Shampa Nasreen | Nurse Practitioner | 2711 E Roosevelt St, Phoenix, AZ 85008-4946 | 2017-09-06 |
| 1306275581 | Melissa Kay Reichenbach | Nurse Practitioner | 444 W. Osborn Rd, Ste 301, Phoenix, AZ 85013-3896 | 2013-11-07 |
| 1831539410 | Michelle Lea Byers | Nurse Practitioner | 17624 North 31st Ave, Phoenix, AZ 85053 | 2013-06-27 |
| 1922356518 | April A Colon | Nurse Practitioner | 1919 E Thomas Road, Phoenix, AZ 85016-7710 | 2012-08-29 |
| 1043518707 | Lisette V Hill | Nurse Practitioner | 3802 N 53rd Avenue, Suite 160, Phoenix, AZ 85031 | 2011-03-04 |
| 1376853077 | Tara Leigh Pierce | Nurse Practitioner | 1661 E Camelback Rd Ste 170, Phoenix, AZ 85016-3921 | 2010-10-15 |
| 1144385634 | Deborah Biringer Anderson | Nurse Practitioner | 26224 N Tatum Blvd Ste 1, Phoenix, AZ 85050-7500 | 2006-12-26 |
| 1952408411 | Genny Marie Stiller | Nurse Practitioner | 1919 E. Thomas Road, Department of Hem/onc, Phoenix, AZ 85016 | 2006-09-19 |
| 1437256153 | Pamela K. Grant | Nurse Practitioner | 15420 N. 32nd Drive, Phoenix, AZ 85053-3998 | 2006-09-17 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.