Mary Ellington Aprn LLC
Organization Active NPI Family Nurse Practitioner · Dixon, KY
NPI 1073324232 · NPPES record last updated Jan 16, 2025
Key facts
- NPI
- 1073324232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- MARY ELLINGTON APRN LLC
- Practice address
- 1871 US Highway 41As
Dixon, KY 42409-9448 - Phone
- (270) 543-6372
- Fax
- (270) 440-0007
- NPI assigned
- Jan 16, 2025
- Organization subpart
- No
Authorized official
- Name
- Mary Virginia Ellington, APRN
- Title
- Owner
- Phone
- (270) 543-6372
Practitioners 1
-
Mary Virginia Ellington, NURSE PRACTITIONER
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250411002210 | KY | Part B Supplier - Clinic/Group Practice | 2567986482 |
Receives reassigned benefits from 1 practitioner Practice locations: Dixon, KY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
1871 US Highway 41As
Dixon, KY 42409-9448
Mailing address
1870 Shakerag Rd
Hanson, KY 42413-9698
Phone (270) 543-6372
Other providers in Dixon, KY
- Regina M Elder
- Mary Virginia Ellington
- Green River District Health Dept
- Hometown Apothecary
- Hometown Care LLC
- Methodist Health, Inc.
- Teresea N. Miller
- Owensboro Health Medical Group Inc
- Reaching Potential, LLC
- Jamie Risch
All providers in Dixon, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.