MRS. SHONTA ELLISON (NPI# 1487138608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487138608 |
Entity Type | Individual |
Full Name | MRS. SHONTA ELLISON |
Credential | APRN |
Practice Address |
130 Lake Valley Dr Maumelle AR 72113-5939 |
Practice Telephone | 5017661884 |
Mailing Telephone | 5017661884 |
Enumeration Date | 2018-09-24 |
Last Update Date | 2018-09-24 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 364SA2200X |
Clinical Nurse Specialist Specialization: Adult Health |
S002325 | AR | Physician Assistants & Advanced Practice Nursing Providers |
N | 364SG0600X |
Clinical Nurse Specialist Specialization: Gerontology |
S002325 | AR | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | CNS | S002325 | 01 |
Street Address |
130 LAKE VALLEY DR |
City | MAUMELLE |
State | AR |
Zip Code | 72113-5939 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104347814 | Shasta Dockery | Registered Nurse | 15020 Wade Blvd., North Little Rock, AR 72113 | 2017-07-03 |
1235669839 | Robert Mitchell Fisher | Specialist/Technologist | 134 Vienne Pl, Maumelle, AR 72113 | 2017-06-15 |
1932516887 | Healthcare Express, LLP | Clinic/Center | 11819 Maumelle Blvd., North Little Rock, AR 72113 | 2014-07-11 |
1184997991 | Preston Lewis | Speech-Language Pathologist | 14 Braeswood Place, Maumelle, AR 72113 | 2012-02-10 |
1740437813 | Jennifer L Franklin | Social Worker | 115 Audubon Dr Ste 9a, Maumelle, AR 72113 | 2008-08-20 |
1861655912 | Dawn Melton Mulkern | Dietitian, Registered | 12 Ninth Fairway Loop, Maumelle, AR 72113 | 2008-07-09 |
1902028723 | Robin Reynolds | Dietitian, Registered | 9300 White Oak Crossing, N Little Rock, AR 72113 | 2007-05-02 |
1316096498 | Caretech Medical, Inc. | Durable Medical Equipment & Medical Supplies | 8010 Counts Massie Rd, Suite B, North Little Rock, AR 72113 | 2007-01-09 |
1548318470 | Supermarket Investors Inc | Pharmacy | 1117 Audubon Dr, Maumelle, AR 72113 | 2007-01-08 |
1821177353 | Maumelle Investments & Associates, LLC | Skilled Nursing Facility | 103 Alexandria Drive, Maumelle, AR 72113 | 2006-11-03 |
Find all providers in zip 72113 |
Taxonomy Code | 364SA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
1275182677 | Central Arkansas Screening and Medical Services | Clinical Nurse Specialist | 801 W. Locust St, Cabot, AR 72023 | 2019-09-09 |
1740731660 | Holly Bunn | Clinical Nurse Specialist | 41 Harding Dr, Searcy, AR 72143-5704 | 2016-10-14 |
1457808362 | Candice Caldwell | Clinical Nurse Specialist | 1809 Ozarka College Dr, Mountain View, AR 72560-6455 | 2016-09-08 |
1548672413 | Angela Pugsley | Clinical Nurse Specialist | 900 Enterprise Dr, Jonesboro, AR 72401-9239 | 2014-05-27 |
1104164706 | Betty D Corley | Clinical Nurse Specialist | 4 Redhead Dr, Conway, AR 72032-9756 | 2013-01-17 |
1255677027 | Brandi Nicole Sharp | Clinical Nurse Specialist | 421 W Wade Ave, Mountain Home, AR 72653-4622 | 2012-12-21 |
1760744080 | Elizabeth H Jarvis | Clinical Nurse Specialist | 500 S University Ave Ste 500, Little Rock, AR 72205-5307 | 2012-06-12 |
1134489842 | Barbara Frances Gray | Clinical Nurse Specialist | 2020 Hytrol St, Jonesboro, AR 72401-6712 | 2012-05-29 |
1881913408 | Nelson Andrew Seal | Clinical Nurse Specialist | 4 Charithcher Ln, Bella Vista, AR 72714-3247 | 2010-05-21 |
Find all providers with the same taxonomy |
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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.