Elizabeth A. Ellis, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-106812 Issued in AL

Practice address

2812 Hartford Hwy Ste 1
Dothan, AL 36305-4927

Phone

(334) 712-1170

Fax

(334) 460-8391

NPI assigned

May 23, 2023

Sex

Female

Sole proprietor

Yes

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 AL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: alabamaclinics.elizabethellis@157820.advancedmd-direct.com

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

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

{
    "created_epoch": "1684800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1104518596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 N COUNTY ROAD 67",
            "city": "SKIPPERVILLE",
            "state": "AL",
            "postal_code": "363745834",
            "telephone_number": "334-701-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 HARTFORD HWY STE 1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054927",
            "telephone_number": "334-712-1170",
            "fax_number": "334-460-8391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1970 Andrews Ave",
            "address_purpose": "LOCATION",
            "city": "Ozark",
            "state": "AL",
            "postal_code": "363603726",
            "country_code": "US",
            "telephone_number": "334-774-1555",
            "fax_number": "334-443-0213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ELIZABETH",
        "middle_name": "A.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-23",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-106812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Neurospine & Vascular Institute LLC
• William Troy Elkington, M.D.
• Lynette M Elkins, CRNP
• Barbara Denise Ellenburg, PT
• Jeffrey M Elliott, MD
• Janet Lynn Ellis, M.S.W., L.C.S.W., PI
• Jeannette K. Ellis, REGISTERED NURSE
• Melanie Jo Ellison, NP
• Emblom & Vaughn, D.M.D., PC
• Robert G Emblom, DMD

• Family Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.