MARY ELLIS (NPI# 1720594088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720594088 |
| Entity Type | Individual |
| Full Name | MARY ELLIS |
| Practice Address |
3533 Southern Blvd Ste 5200 Kettering OH 45429-1275 |
| Mailing Address |
3640 Colonel Glenn Hwy Dayton OH 45435-0001 |
| Practice Telephone | 9373958043 |
| Practice Fax Number | 9373958139 |
| Mailing Telephone | 9377753458 |
| Mailing Fax Number | 9377753434 |
| Enumeration Date | 2017-12-22 |
| Last Update Date | 2017-12-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881224996 | Mary Elizabeth Ellis | Physician Assistant | 1 Hospital Dr # 3400, Asheville, NC 28801-4550 | 2020-01-17 |
| 1730517293 | Mary Hannah Ellis | Counselor | 703 Copperline Dr, Unit 208, Chapel Hill, NC 27516-4488 | 2013-10-21 |
| 1295042869 | Mary Ann Ellis | Counselor | 20114 E Pennsylvania Ave, Dunnellon, FL 34432-6033 | 2010-09-02 |
| 1437486172 | Mary Ellis | Licensed Practical Nurse | 3073 Prosperity Ln, Columbus, OH 43231-8822 | 2009-11-17 |
| 1588816573 | Mary Louise Ellis | Pharmacist | 1327 Blue Ave, Zanesville, OH 43701-2403 | 2008-10-21 |
| 1821297300 | Mary Lucena Ellis | Speech-Language Pathologist | 2810 45th St, Rock Island, IL 61201-5860 | 2007-07-13 |
| 1437360872 | Mary Louise Ellis | Registered Nurse | 20094 Mission Blvd, Hayward, CA 94541-1237 | 2007-05-25 |
| 1003964131 | Mary Linda Ellis | Counselor | 2070 Buford Hwy, Ste 2-d, Buford, GA 30518-6079 | 2007-01-08 |
| 1982268231 | Mary Claire Ellis | Student in an Organized Health Care Education/Training Program | Duke University Hospital 2301 Erwin Rd, Durham, NC 27710-0001 | 2019-04-23 |
| 1295295814 | Mary Allison Ellis | Pharmacist | 800 Rose St Rm H110, Lexington, KY 40536-0293 | 2019-03-20 |
| Street Address |
3533 SOUTHERN BLVD STE 5200 |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-1275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184157810 | Jon Curtis Martin | Student in an Organized Health Care Education/Training Program | 142 Balmoral Dr, Kettering, OH 45429-1710 | 2017-04-10 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1285082784 | Joshua Dalzell | Student in an Organized Health Care Education/Training Program | 2629 Colonial Ave, Kettering, OH 45419-2339 | 2016-05-25 |
| 1043624935 | Douglas K Armour | Student in an Organized Health Care Education/Training Program | 608 Broad Blvd, Kettering, OH 45419-1901 | 2014-06-18 |
| 1356661466 | Gabrielle Willey | Student in an Organized Health Care Education/Training Program | 3535 Southern Blvd Ste 210, Kettering, OH 45429-1221 | 2010-06-11 |
| 1750614228 | Charles Jeremy Mears | Student in an Organized Health Care Education/Training Program | Wsu Emergency Medicine, 3525 Southern Blvd, Kettering, OH 45429 | 2009-09-15 |
| 1023288008 | Missole Cadet-patterson | Student in an Organized Health Care Education/Training Program | 1502 Tabor Ave, Kettering, OH 45420-2137 | 2008-03-06 |
| 1174704555 | Lauren Marie Cimperman | Student in an Organized Health Care Education/Training Program | 2046 Richfield Dr, Kettering, OH 45420-2012 | 2007-11-14 |
| 1558990895 | Paxton James Prather | Student in an Organized Health Care Education/Training Program | 3525 Southern Blvd, Kettering, OH 45429-1221 | 2020-04-08 |
| 1801425889 | Jacob John Patz | Student in an Organized Health Care Education/Training Program | 3525 Southern Blvd, Kettering, OH 45429-1221 | 2020-04-02 |
| Find all providers in KETTERING | ||||
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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.