Carly Ellis, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

134060 Issued in VT

Practice address

1824 VT 11
Chester, VT 05143-8621

Phone

(610) 906-5514

NPI assigned

Jun 21, 2011

Last updated

Dec 4, 2024By the provider in NPPES

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

Other names 1

• Dr. Carly Davis Former name

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Lake Erie College of Osteopathic Medicine, Erie, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brattleboro Memorial HospitalGroup PAC ID 9335112929, 70 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brattleboro Memorial Hospital Hospital, Brattleboro, VT, CCN 470011
• Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/d9dc001d-1bc5-42f9-bd4d-eb79208fd32a/

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.

• Brattleboro Memorial Hospital

  • General Acute Care Hospital
  • Brattleboro, VT
  • NPI 1306849708

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• House Call Group, PC

  • Family Medicine Physician
  • Flourtown, PA
  • NPI 1235136904
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brattleboro Memorial Hospital

  • General Acute Care Hospital
  • Brattleboro, VT
  • NPI 1306849708
  Care Compare affiliation
• Mary Hitchcock Memorial Hospital

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1023092053
  Care Compare affiliation
• Mary Hitchcock Memorial Hospital

  dba MHMH Regional Services

  • General Acute Care Hospital
  • Lebanon, NH
  • NPI 1629788237
  Care Compare affiliation

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1144516857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 VT 11",
            "city": "CHESTER",
            "state": "VT",
            "postal_code": "051438621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 VT 11",
            "city": "CHESTER",
            "state": "VT",
            "postal_code": "051438621",
            "telephone_number": "610-906-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CARLY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VT",
            "license": "134060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "DAVIS",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katrina Boissonnault, RN
• Heather Collie Chase, MS,RN,IBCLC
• Mara E. Cicaloni, M.S., LCMHC
• Corporate Lactation Services, Inc (Comprehensive Lactation Services)
• Corporate Lactation Services, Inc
• Equipoise Occupational Therapy, PLLC
• Julie Lynn Flack, D.C.
• Sheryl S Fratino, REG DENTAL HYGIENIST
• Kathyrn J Harris, RN
• Elizabeth Katherine Hudson Adams, M.ED.

• Internal Medicine Physician in Chester, VT
• Providers in Chester, VT by specialty
• Internal Medicine Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.
• 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.