MICHELL R ELLIS (NPI# 1871919845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871919845 |
| Entity Type | Individual |
| Full Name | MICHELL R ELLIS |
| Credential | PHARMD |
| Practice Address |
2 Good Samaritan Way Suite 120 Mount Vernon IL 62864-2408 |
| Practice Telephone | 6188994999 |
| Practice Fax Number | 6188994799 |
| Mailing Telephone | 6188994999 |
| Mailing Fax Number | 6188994799 |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2014-03-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 051.292773 | IL | Pharmacy Service Providers |
| Street Address |
2 GOOD SAMARITAN WAY SUITE 120 |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-2408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093718900 | Ssm Health Businesses | Hospice Care, Community Based | 2 Good Samaritan Way, Suite 325, Mount Vernon, IL 62864-2408 | 2005-05-24 |
| 1417573734 | Scherrie Lynn Medina | Registered Nurse | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2020-06-23 |
| 1245711779 | Mary K Mcgarvey | Occupational Therapy Assistant | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2018-08-23 |
| 1831611334 | Patricia Isabel Calcetto | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2017-07-17 |
| 1821548207 | Nicole Vetter | Nurse Practitioner | 2 Good Samaritan Way, Medical Plaza Suite 420, Mount Vernon, IL 62864-2408 | 2016-10-10 |
| 1740654821 | Kathryn Flanigan | Speech-Language Pathologist | 2 Good Samaritan Way, 3rd Floor, Mount Vernon, IL 62864-2408 | 2015-11-30 |
| 1275900656 | Christopher Bourget | Registered Nurse | 2 Good Samaritan Way, Medical Plaza Suite 205, Mount Vernon, IL 62864-2408 | 2015-09-01 |
| 1992188338 | Carl Robert Davis | Nurse Anesthetist, Certified Registered | 2 Good Samaritan Way, Suite 205, Mount Vernon, IL 62864-2408 | 2015-07-02 |
| 1548685647 | Rebecca Breanne Ritchey | Speech-Language Pathologist | 2 Good Samaritan Way, Mount Vernon, IL 62864-2408 | 2014-02-26 |
| 1275954778 | Karla Webb | Nurse Practitioner | 2 Good Samaritan Way, Suite 220, Mount Vernon, IL 62864-2408 | 2013-12-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780296509 | Jordan Lee Erickson | Pharmacist | 2109 E Broadway, Mount Vernon, WA 98274-4628 | 2020-08-21 |
| 1851920342 | Branda Truong | Pharmacist | 306 Texas Highway 37, Mount Vernon, TX 75457-3112 | 2020-04-06 |
| 1003449851 | Rachel Octavia Wylie | Pharmacist | 1226 Mulberry St, Mount Vernon, IN 47620-1358 | 2020-02-20 |
| 1689180184 | Samuel Cooke Ingraham IIi | Pharmacist | 618 E High St, Mount Vernon, OH 43050-2747 | 2017-12-19 |
| 1689120412 | Kendall Keith Kilbourne | Pharmacist | 410 Richmond, Mount Vernon, KY 40456-0796 | 2016-08-31 |
| 1336502996 | Timothy Lynn | Pharmacist | 3404 Broadway St, Mount Vernon, IL 62864-2267 | 2016-03-31 |
| 1548676323 | Tina Chang-yip | Pharmacist | 211 E Sandford Blvd, Mount Vernon, NY 10550-4623 | 2014-07-01 |
| 1477835114 | Sara Elizabeth Koebele | Pharmacist | 3001 Broadway St, Mount Vernon, IL 62864-2361 | 2011-09-19 |
| 1881976355 | Shimrote Ishaque | Pharmacist | 424 E. College Wa, Mount Vernon, WA 98273 | 2011-09-12 |
| 1144518143 | Hebat Allah Bakhach | Pharmacist | 242 E College Way, Mount Vernon, WA 98273-5432 | 2011-07-12 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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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.