Amber M Ellis (NPI# 1093049983, PAC ID# 7113068057) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1093049983 |
| PAC ID by PECOS | 7113068057 |
| Professional Enrollment ID | I20100114000031 |
| Full Name | Amber M Ellis |
| Organization Legal Name | LIVING WATERS MEDICAL CENTER |
| Address |
100 Main Ave Logan WV 25601-3323 |
| Phone Number | 3048962553 |
| Gender | F |
| Graduation Year | 2009 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 2769711019 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 510048 | LOGAN REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 100 Main Ave, Logan, WV 25601-3323 | 3048962553 | LIVING WATERS MEDICAL CENTER |
| Organization Legal Name | LIVING WATERS MEDICAL CENTER |
| Physicians | 1 |
| Street Address |
100 MAIN AVE |
| City | LOGAN |
| State | WV |
| Zip | 25601-3323 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jamie L Hall-jasper | Podiatry | 100 Main Ave, Logan, WV 25601-3323 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ahmad B Faridi | Internal Medicine | Southern West Virginia Nephrology Associates | 300 Prosperity Dr, Suite 203, Logan, WV 25601-0300 |
| Melissa Kitchen | Nurse Practitioner | Southern West Virginia Nephrology Associates | 300 Prosperity Dr, Suite 203, Logan, WV 25601-0300 |
| Karunasree Kanuri | Family Medicine | 1115 2nd Ave, West Logan, WV 25601-3309 | |
| Douglas K Hibbs | Physical Therapy | 364 Riverview Ave, Logan, WV 25601-3428 | |
| Jennifer Marie Oneal | Physical Therapy | 364 Riverview Ave, Logan, WV 25601-3428 | |
| Emad Y Mousa | Obstetrics/gynecology | 77 Hospital Dr, Suite 200, Logan, WV 25601-3451 | |
| Zial Salem | Gastroenterology | Logan General Hospital LLC | 79 Hospital Dr, Logan, WV 25601-3451 |
| Michael B Beres | Ophthalmology | 77 Hospital Dr, Suite 401, Logan, WV 25601-3451 | |
| Safique Ahmed | Hematology/oncology | 77 Hospital Dr, Suite 301, Logan, WV 25601-3451 | |
| Nicole L Dillon | Family Medicine | 77 Hospital Dr, Doctors Park Suite D, Logan, WV 25601-3451 | |
| Find all physicians in zip 25601 | |||
| City | LOGAN |
| Zip Code | 25601 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | LOGAN + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Amber M Ellis.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.