GAYLE M. ELLIS (NPI# 1295890259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295890259 |
| Entity Type | Individual |
| Full Name | GAYLE M. ELLIS |
| Practice Address |
700 Ray O Vac Dr Suite 220 Madison WI 53711-2479 |
| Practice Telephone | 6082769191 |
| Practice Fax Number | 6082769144 |
| Mailing Telephone | 6082769191 |
| Mailing Fax Number | 6082769144 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103TC0700X |
Psychologist Specialization: Clinical |
2432-057 | WI | Behavioral Health & Social Service Providers |
| X | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
1526-033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| X | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
WI | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 3914300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407006778 | Gayle Ellis | Speech-Language Pathologist | 5001 S 69th St, Lincoln, NE 68516-1566 | 2008-09-23 |
| Street Address |
700 RAY O VAC DR SUITE 220 |
| City | MADISON |
| State | WI |
| Zip Code | 53711-2479 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316985369 | Communication Development Center, Inc. | Speech-Language Pathologist | 700 Ray O Vac Dr, Suite 200, Madison, WI 53711-2479 | 2006-06-03 |
| 1881058675 | Peter C. Jackson, Psyd Consulting, Sc | Psychologist | 700 Ray O Vac Dr, Suite 220, Madison, WI 53711-2479 | 2016-04-08 |
| 1932585940 | Kind Therapy, LLC | Community/Behavioral Health | 700 Ray O Vac Dr, Suite 103, Madison, WI 53711-2479 | 2015-08-03 |
| 1568803336 | Laura K Johnson | Counselor | 700 Ray O Vac Dr, 103, Madison, WI 53711-2479 | 2013-07-09 |
| 1013073022 | Thorsten W. Horton | Social Worker | 700 Ray O Vac Dr, Suite 220, Madison, WI 53711-2479 | 2006-12-28 |
| 1023173234 | Vincent H. Fish | Psychologist | 700 Ray O Vac Dr, Suite 220, Madison, WI 53711-2479 | 2006-12-27 |
| 1710042858 | Erica R. Serlin | Psychologist | 700 Ray O Vac Dr, Suite 220, Madison, WI 53711-2479 | 2006-12-27 |
| 1801951843 | Abigail M. Young | Psychiatry & Neurology | 700 Ray O Vac Dr, Suite 220, Madison, WI 53711-2479 | 2006-12-27 |
| 1942365994 | Peter C. Jackson | Psychologist | 700 Ray O Vac Dr, Suite 220, Madison, WI 53711-2479 | 2006-12-27 |
| 1245395425 | Anne S. Beal | Social Worker | 700 Ray O Vac Dr, Suite 220, Madison, WI 53711-2479 | 2006-12-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487296307 | Exact Sciences Laboratories, LLC | Clinical Medical Laboratory | 650 Forward Drive, Madison, WI 53711 | 2019-10-11 |
| 1508417916 | Cassandra D Pasquariello | Psychologist | Department of Athletics, 1440 Monroe Street, Madison, WI 53711 | 2019-09-26 |
| 1972161628 | Leah Bastian | Marriage & Family Therapist | 2935 S Fish Hatchery Rd # 244, Madison, WI 53711 | 2019-05-29 |
| 1457810673 | Leah Smith | Specialist/Technologist | 1436 Monroe Street, Madison, WI 53711 | 2019-03-18 |
| 1669942249 | Patrick Soltvedt Bohn | Physician Assistant | 1034 Waban Hill, Madison, WI 53711 | 2018-11-27 |
| 1760975395 | Alysha Rolli | Dentist | 2945 Triverton Pike Dr, Fitchburg, WI 53711 | 2018-06-08 |
| 1265922561 | Farence Rogers | Student in an Organized Health Care Education/Training Program | 1475 Engineering Dr. Madison, Madison, WI 53711 | 2018-05-14 |
| 1588015358 | Kristen Siskovich | Speech-Language Pathologist | 2927 Fish Hatchery Rd., Fitchburg, WI 53711 | 2016-06-23 |
| 1598132383 | Shari Eberhardt | Nurse Practitioner | Journey Mental Health Center, 25 Kessel Ct, Madison, WI 53711 | 2015-08-27 |
| 1649646506 | Oak Park Place of Nakoma, LLC | Skilled Nursing Facility | 4327 Nakoma Road, Madison, WI 53711 | 2015-08-14 |
| Find all providers in zip 53711 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770196842 | Ariel C Breaux | Psychologist | 800 Bus Stop Dr, Madison, IN 47250 | 2020-08-28 |
| 1508417916 | Cassandra D Pasquariello | Psychologist | Department of Athletics, 1440 Monroe Street, Madison, WI 53711 | 2019-09-26 |
| 1497311294 | Brenda Sue Stepak | Psychologist | 4 Giralda Farms, Madison, NJ 07940 | 2019-05-16 |
| 1407327844 | Deborah Ann Pape | Psychologist | 350 S. Hamilton St., Unit 504, Madison, WI 53703 | 2018-12-11 |
| 1598232548 | Different Minds LLC | Psychologist | 313 Price Pl Ste 109, Madison, WI 53705-3262 | 2018-10-29 |
| 1760967145 | Emily Cahill Forscher | Psychologist | 2801 International Ln, Madison, WI 53704-3119 | 2018-10-01 |
| 1083167944 | Monica Ballard-booth | Psychologist | 331 State St, Suite 300, Madison, WV 25130-1367 | 2016-07-27 |
| 1750758033 | Patricia Humphrey | Psychologist | 4785 Hayes Rd Ste 100, Madison, WI 53704-7364 | 2015-08-21 |
| 1417348046 | Roger Rattan | Psychologist | 516 Troy Dr, Madison, WI 53704-1575 | 2015-02-18 |
| 1427453877 | Forward Psychology Group | Psychologist | 478 Commerce Dr Ste 204, Madison, WI 53719-5099 | 2014-10-28 |
| Find all providers in MADISON | ||||
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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.