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Active NPI 1407669344 Individual Practitioner Female Practitioner

Ebony T Sallis , LPN

Licensed Practical Nurse • Laveen, AZ

Professional Overview & Biography Verified Profile Summary

Ebony Sallis, LPN is a registered healthcare professional specializing in Licensed Practical Nurse in Laveen, AZ. Practice services are available at 3921 W BASELINE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3921 W Baseline Rd

Laveen, AZ 853391801

Telephone 6236067532

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Laveen, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
9 Specialists

Practicing in Laveen, AZ (1065 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-01-23
Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License GA LPN092214

An individual 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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

15 Associated Practitioners
Jake Yamasaki

Registered Nurse - School

NPI 1043948862
Melody Aros

Registered Nurse - School

NPI 1073113825
Derek Carbajal , RN

Registered Nurse - School

NPI 1083499925

Registered Nurse

Karli Dieu , MS, CCC-SLP

Speech-Language Pathologist

NPI 1205528510

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

NPI 1245204163

MSATC

Abigail Ross

Specialist/Technologist - Speech-Language Assistant

NPI 1265206205

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active January 27, 2025

NPI status registered as active in NPPES database

📍
Updated Practice Location January 27, 2025

Registered at 3921 W BASELINE RD, LAVEEN, AZ 853391801 (Tel: 6236067532)

📍
Updated Business Mailing Address January 27, 2025

Registered at 250 APPLEWOOD DR UNIT 3004, LAWRENCEVILLE, GA 300466409 (Tel: 6236067532)

👤
Provider Name / Credentials Updated January 27, 2025

Recorded as EBONY SALLIS, LPN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 27, 2025

Licensed Practical Nurse (License #LPN092214 in GA)

🟢
Initial NPI Registration & Enumeration January 27, 2025

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1407669344
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 27, 2025
Last Update: January 27, 2025
Sole Proprietor: Yes

Mailing Address

250 Applewood Dr Unit 3004

Lawrenceville, GA 300466409

Phone: 6236067532

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.