KEITH LAWRENCE ELLIS (NPI# 1144654666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144654666 |
| Entity Type | Individual |
| Full Name | KEITH LAWRENCE ELLIS |
| Practice Address |
46 Albion St Bridgeport CT 06605-2602 |
| Practice Telephone | 2033306000 |
| Practice Fax Number | 2033306008 |
| Mailing Telephone | 2033306000 |
| Mailing Fax Number | 2033306008 |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2014-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
5501 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004236136 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407849441 | Keith L Ellis | Marriage & Family Therapist | 557 Glover Ave, Suite 3, Enterprise, AL 36330-2024 | 2005-08-24 |
| 1194166942 | Keith Ellis | Counselor | 11 Ward St, Somerville, MA 02143-4214 | 2013-07-09 |
| 1972823367 | Keith Ellis | Physical Therapist | 751 E Porter Ave Ste 2, Chesterton, IN 46304-9111 | 2010-06-08 |
| 1356490775 | Keith Errett Ellis | Family Medicine | 1107 E 66th St, Savannah, GA 31404-5701 | 2007-01-09 |
| 1033275896 | Keith W. Ellis | Internal Medicine | 2115 S Fremont Ave, Suite 2300, Springfield, MO 65804-2239 | 2006-12-28 |
| Street Address |
46 ALBION ST |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06605-2602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801898804 | Jose A Camacho-pantoja | Psychiatry & Neurology | 46 Albion St, Southwest Community Health Center, Inc, Bridgeport, CT 06605-2602 | 2005-08-10 |
| 1790302933 | Kelly Yorio | Nurse Practitioner | 46 Albion St, Bridgeport, CT 06605-2602 | 2020-07-04 |
| 1316564396 | Catherine Marie Howe | Registered Nurse | 46 Albion St, Bridgeport, CT 06605-2602 | 2020-06-25 |
| 1275178261 | Anna Marie Washington | Social Worker | 46 Albion St, Bridgeport, CT 06605-2602 | 2019-11-13 |
| 1144876608 | Jessie Gay | Nurse Practitioner | 46 Albion St, Bridgeport, CT 06605-2602 | 2019-08-12 |
| 1881248136 | Ntohmabi Ndingwan | Nurse Practitioner | 46 Albion St, Bridgeport, CT 06605-2602 | 2019-07-25 |
| 1548813090 | Nikki Marie Carino | Nurse Practitioner | 46 Albion St, Bridgeport, CT 06605-2602 | 2019-07-23 |
| 1235790296 | Hudson I Hector | Dental Hygienist | 46 Albion St, Bridgeport, CT 06605-2602 | 2019-06-20 |
| 1235603044 | Katherine Esaw | Social Worker | 46 Albion St, Bridgeport, CT 06605-2602 | 2019-01-15 |
| 1013484088 | Samantha Mraz | Nurse Practitioner | 46 Albion St, Bridgeport, CT 06605-2602 | 2018-10-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497312276 | Stacy-ann Thompson-grant | Social Worker | 170 Bennet T Street, Bridgeport, CT 06605 | 2019-05-28 |
| 1720502149 | Sheree Amankwah | Counselor | 170 Bennett Street, Bridgeport, CT 06605 | 2017-07-27 |
| 1417477324 | Aracelis Robertson | Case Manager/Care Coordinator | 1646 Fairfield Avenue, 3rd Floor, Bridgeport, CT 06605 | 2017-06-21 |
| 1699158170 | Cortney Davis | Physician Assistant | 3250 Fairfield Ave, Unit 217, Bridgeport, CT 06605 | 2015-07-02 |
| 1083020051 | Douglas Mccoy | Nurse Practitioner | 46 Albion St., Bridgeport, CT 06605 | 2014-07-10 |
| 1932513785 | Hallie Claire Riggs | Social Worker | 1730 State St Ext, Bridgeport, CT 06605 | 2014-06-19 |
| 1831518513 | Yvonne Booy | Counselor | 46 Albion Street, Bridgeport, CT 06605 | 2014-04-10 |
| 1760556955 | Joel W Allen | Obstetrics & Gynecology | 625 Clinton Ave, Bridgeport, CT 06605 | 2006-11-20 |
| 1316046428 | Allen P Schlein | Orthopaedic Surgery | 650 Clinten Avenue, Bridgeport, CT 06605 | 2006-09-22 |
| 1336127984 | Hancock Pharmacy | Pharmacy | 1557 Fairfield Ave, Bridgeport, CT 06605 | 2006-01-04 |
| Find all providers in zip 06605 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083020051 | Douglas Mccoy | Nurse Practitioner | 46 Albion St., Bridgeport, CT 06605 | 2014-07-10 |
| 1295711331 | Polly F Cromwell | Nurse Practitioner | 752 E Main St, Bridgeport, CT 06608-2335 | 2005-12-20 |
| 1629053889 | Nancy Irene Munn | Nurse Practitioner | 680 Park Ave, Bridgeport, CT 06604-4610 | 2005-12-09 |
| 1396225355 | Kimberly Rose Cifelli | Nurse Practitioner | 46 Albion St, Bridgeport, CT 06605-2602 | 2018-08-20 |
| 1487191102 | Judie Kane | Nurse Practitioner | 900 Lodgeville Rd, Bridgeport, WV 26330-1488 | 2017-01-20 |
| 1093269185 | Yejin Lee | Nurse Practitioner | 46 Albion St, Bridgeport, CT 06605-2602 | 2016-08-07 |
| 1043685308 | Asena Derohannesian | Nurse Practitioner | 425 Thorme St, Bridgeport, CT 06606-3418 | 2015-12-11 |
| 1730598947 | Carolyn Walsh | Nurse Practitioner | 46 Albion St, Bridgeport, CT 06605 | 2014-08-13 |
| 1578998902 | Kayla Renee Watson | Nurse Practitioner | 900 Lodgeville Rd, Bridgeport, WV 26330-1488 | 2013-09-04 |
| 1164864005 | Marnie B Frey | Nurse Practitioner | 267 Grant St, Nbicu, Bridgeport, CT 06610-2805 | 2013-07-19 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06605 |
Please comment or provide details below to improve the information on KEITH LAWRENCE ELLIS.
| 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.