KEISHA ELLIS (NPI# 1508318494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508318494 |
| Entity Type | Individual |
| Full Name | KEISHA ELLIS |
| Credential | NP |
| Practice Address |
601 W Country Club Rd Ste 102 Roswell NM 88201-5227 |
| Practice Telephone | 5756244922 |
| Practice Fax Number | 5756244902 |
| Mailing Telephone | 5756244922 |
| Mailing Fax Number | 5756244902 |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2020-09-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP03387 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
9281197 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 44672322 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 111 W Hobbs St, Roswell, NM 882031869 | 5756233311 | 5756221273 |
| 115 E 23rd St, Roswell, NM 88201 | 5756251292 | 5756244836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629358387 | Keisha Ellis | Physical Therapist | 105 Laura Sue Humphress Dr, Campbellsville, KY 42718-8899 | 2011-08-25 |
| Street Address |
601 W COUNTRY CLUB RD STE 102 |
| City | ROSWELL |
| State | NM |
| Zip Code | 88201-5227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902310022 | Corey A Carter | Specialist/Technologist, Other | 117 E 19th Street, Roswell, NM 88201 | 2017-11-28 |
| 1326598541 | Dove Medical Corporation | Family Medicine | 110 East 3rd Street, Roswell, NM 88201 | 2016-10-12 |
| 1841748381 | Anali Velez | Registered Nurse | 300 N Kentucky, Roswell, NM 88201 | 2016-09-13 |
| 1831647379 | Rebecca Palomino | Registered Nurse | 800 Marion Richards Rd, Roswell, NM 88201 | 2016-09-13 |
| 1215300926 | Heart Path Oriental Medicine | Clinic/Center | 810 N Union, Roswell, NM 88201 | 2015-11-03 |
| 1538564745 | Lacey Scott | Pharmacist | 1835 N. Main, Roswell, NM 88201 | 2014-10-30 |
| 1962815852 | Marium Khan | Internal Medicine | 400 Military Heights Place, Roswell, NM 88201 | 2014-06-09 |
| 1316288913 | Anaya Counseling | Community/Behavioral Health | 613 W 2nd St Ste 4, Roswell, NM 88201 | 2013-03-06 |
| 1205185386 | Rosarita Brady | Occupational Therapist | 300 N. Kentucky, Roswell, NM 88201 | 2012-09-05 |
| 1922360049 | Ashley Spinhirne Thompson | Speech-Language Pathologist | 304 N. Richardson, Roswell, NM 88201 | 2012-06-14 |
| Find all providers in zip 88201 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548869506 | Stephanie Regine Garba | Nurse Practitioner | 4320 Calibre Creek Pkwy, Roswell, GA 30076-4549 | 2020-10-21 |
| 1376141101 | Virginia Ann Peterson | Nurse Practitioner | 330 Clear Creek Ct, Roswell, GA 30076-3013 | 2020-10-14 |
| 1326657453 | Kali Kundomal | Nurse Practitioner | 2500 Brandon Way, Roswell, NM 88201-9799 | 2020-07-24 |
| 1003374968 | We Care General Medical Clinic, LLC | Nurse Practitioner | 615 Colonial Park Dr Ste 103, Roswell, GA 30075-3773 | 2019-03-08 |
| 1760987002 | Meredith Mcwhirter | Nurse Practitioner | 11111 Houze Rd Ste 225, Roswell, GA 30076-5618 | 2018-03-28 |
| 1063934818 | Darla Gene Melton | Nurse Practitioner | 350 W Country Club Rd Ste 105, Roswell, NM 88201-5222 | 2017-07-13 |
| 1144756255 | Kimberly Paris | Nurse Practitioner | 2500 Hospital Blvd Ste 320, Roswell, GA 30076-4947 | 2017-05-10 |
| 1063812741 | Susanne Lester-bennett | Nurse Practitioner | 1805 Old Alabama Rd, Suite 250, Roswell, GA 30076-2259 | 2014-08-29 |
| 1558791665 | Elizabeth Simone | Nurse Practitioner | 8280 Overview Ct, Roswell, GA 30076-3922 | 2013-11-26 |
| 1114269974 | Patricia E Hernandez | Nurse Practitioner | 10479 Alpharetta St Ste 18, Roswell, GA 30075 | 2013-03-20 |
| Find all providers in ROSWELL | ||||
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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.