Earl Edward Ellis, M.ED., LPA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0952 Issued in KY

Practice address

890 Rineyville Rd
Elizabethtown, KY 42701-8927

Phone

(270) 234-9236

Fax

(270) 234-8367

NPI assigned

Jun 11, 2007

Last updated

Aug 29, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Commonwealth of KentuckyGroup PAC ID 0840180816, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Education

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Commonwealth of Kentucky

  dba Hazelwood Specialty Clinic

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1114346467
  Medicare reassignment Care Compare group NPD
• Commonwealth of Kentucky

  dba Carl M.Brashear Radcliff Veterans Center

  • Skilled Nursing Facility
  • Radcliff, KY
  • NPI 1043686900
  NPD
• Advocacy & Support Center

  • Specialist
  • Elizabethtown, KY
  • NPI 1073677746
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1013111459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 RINEYVILLE RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427018927",
            "telephone_number": "270-234-9236",
            "fax_number": "270-234-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 RINEYVILLE RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427018927",
            "telephone_number": "270-234-9236",
            "fax_number": "270-234-8367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "EARL",
        "middle_name": "EDWARD",
        "credential": "M.ED., LPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "0952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laine B. Elkin
• David Elliott, MD
• Patricia Elliott, PBS
• Ellis Professional Counseling Services, LLC (Alice Ellis, LPCC)
• Alice A Ellis, LPCC
• Nicole Renee Ellis, LPCC-S, NCC
• Timothy Ellis, LCSW
• Stephanie Elmore
• Athena V Emerine, SLP
• Encompass Health Rehabilitation Hospital of Lakeview, LLC (Encompass Health Rehabilitation Hospital of Lakeview)

• Psychologist in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.