MRS. AMANDA LEIGH ELLIS (NPI# 1659871424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659871424 |
| Entity Type | Individual |
| Full Name | MRS. AMANDA LEIGH ELLIS |
| Credential | NP-C |
| Practice Address |
501 Marshall St Ste 600 Jackson MS 39202-1650 |
| Mailing Address |
5520 Midway Rd Carthage MS 39051-8626 |
| Practice Telephone | 6019486540 |
| Mailing Telephone | 6014863343 |
| Enumeration Date | 2018-02-17 |
| Last Update Date | 2018-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
902514 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
902514 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
902514 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
902514 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5520 Midway Rd, Carthage, MS 390518626 | 6014863343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902443195 | Amanda L Ellis | Family Medicine | 750 Albemarle Ave, Cuyahoga Falls, OH 44221-4814 | 2019-12-06 |
| 1386138907 | Amanda Frances Ellis | Dietitian, Registered | 915 118th Ave Se, Attention Alecia Johnson, Ret Physica, Suite 110, Bellevue, WA 98005 | 2018-06-18 |
| 1558876748 | Amanda Ellis | Behavior Technician | 2751 Legends Pkwy Ste 2, Prattville, AL 36066-7754 | 2017-12-10 |
| 1194198697 | Amanda Ellis | Residential Treatment Facility, Physical Disabilities | 381 East Brook Street, San Tan Valley, AZ 85140 | 2015-11-05 |
| 1568070654 | Amanda D Ellis | Nurse Practitioner | 3841 Piper St Ste T100, Anchorage, AK 99508-4674 | 2020-07-15 |
| 1336795327 | Amanda Nicole Ellis | Counselor | 128 N 2nd St Ste 202, Clarksville, TN 37040-6460 | 2019-08-15 |
| 1316508930 | Amanda Ellis | Behavior Technician | 300 Saint Andrews Rd Ste 408, Saginaw, MI 48638 | 2019-06-25 |
| 1972164689 | Amanda Elizabeth Ellis | Counselor | 1909 Ky 3439, Barbourville, KY 40906-7201 | 2019-06-24 |
| 1649836024 | Amanda Ellis | Dentist | 1001 Covington St, Youngstown, OH 44510-1617 | 2019-05-12 |
| 1780145029 | Amanda Ellis | Counselor | 21545 Centre Pointe Pkwy, Santa Clarita, CA 91350-2947 | 2019-03-28 |
| Street Address |
501 MARSHALL ST STE 600 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-1650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396161493 | James L. Moore, Jr., M.d., P.a. | Obstetrics & Gynecology | 501 Marshall St Ste 600, Jackson, MS 39202-1650 | 2014-03-13 |
| 1609292705 | John D. Isaacs Jr., M.d., P.a. | Obstetrics & Gynecology | 501 Marshall St Ste 600, Jackson, MS 39202-1650 | 2014-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225675952 | Victoria Delores Brown | Nurse Practitioner | 5155 Keele St Apt 22d, Jackson, MS 39206-4331 | 2019-12-02 |
| 1609255520 | Neta J Roby | Nurse Practitioner | Hwy 36, Georgia Diagnostic Classification Prison, Jackson, GA 30233 | 2015-05-26 |
| 1346652377 | Rachel Nichole Ford | Nurse Practitioner | 5963 I 55 N, Jackson, MS 39213-9722 | 2014-05-26 |
| 1760601967 | Kimberly Lynne Schlagel | Nurse Practitioner | 1200 N State St Ste 430, Jackson, MS 39202-2027 | 2007-04-25 |
| 1134117963 | Gloria Lee Kent | Nurse Practitioner | 100 Mission Boulevard, Suite 2800, Jackson, CA 95642-2147 | 2005-10-06 |
| 1265966634 | Tayler M Johnston | Nurse Practitioner | 72 Physicians Dr, Jackson, TN 38305 | 2017-04-12 |
| 1891236725 | Christina Purviance | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2017-03-11 |
| 1407273071 | Lisa Rudd | Nurse Practitioner | 3305 Spring Arbor Rd, Jackson, MI 49203-3794 | 2014-03-21 |
| 1447689799 | Jessica L Rider | Nurse Practitioner | 244 Coatsland Dr, Jackson, TN 38301-3948 | 2013-11-07 |
| 1154669786 | Lakendria Zollicoffer | Nurse Practitioner | 3502 W Northside Dr, Jackson, MS 39213-4454 | 2013-01-16 |
| Find all providers in JACKSON | ||||
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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.