Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

JARED MICHAEL ELLIS LPN
NPI 1336077205
Licensed Practical Nurse in Charlotte, NC

Q: What is Jared Ellis's NPI number?

The NPI number for Jared Ellis is 1336077205. It was assigned to this individual provider in the NPPES registry on May 11, 2026.

Q: What is Jared Ellis's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Q: When was this NPI record last updated?

The NPPES record for Jared Ellis was last updated on May 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 11, 2026

10660 PARK RD STE 3400, CHARLOTTE, NC 28210(704) 667-3840 Get Directions Write a Review

NPPES record added: May 11, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jared Michael Ellis Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JARED MICHAEL ELLIS LPN (NPI 1336077205) is an individual licensed practical nurse in Charlotte, North Carolina, licensed in South Carolina (57164) and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1336077205

Entity TypeIndividualMale

Primary Taxonomy164W00000X

Provider Legal NameJARED MICHAEL ELLISCredential: LPN

Location Address10660 PARK RD STE 3400Charlotte, NC 28210-8461

Mailing Address716 Cody CtFort Mill, SC 29715-7092 · (234) 281-4781

Phone(704) 667-3840

Sole ProprietorNo

Enumeration DateMay 11, 2026

NPPES CertifiedMay 11, 2026

✔ NPI 1336077205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers

Taxonomy Code164W00000X

License✔ Licensed in SC · 57164

Definition

A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

10660 PARK RD STE 3400, Charlotte, NC 28210

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. OMAR LAZARO ESPONDA M.D.

Phlebology

10660 PARK RD STE 3400
CHARLOTTE, NC 28210

Mecklenburg County (704) 667-3840

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jared Ellis's NPI number?

The NPI number for Jared Ellis is 1336077205. It was assigned to this individual provider in the NPPES registry on May 11, 2026.

Where is Jared Ellis located?

Jared Ellis practices at 10660 Park Rd Ste 3400, Charlotte, NC 28210. The listed phone number is (704) 667-3840.

What is Jared Ellis's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Jared Ellis was last updated on May 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.