Amber Nicole Ellis, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F10171219 Issued in OK

Practice address

3209 S Broadway Ste 229
Edmond, OK 73013-4064

Phone

(551) 295-8223

NPI assigned

Sep 27, 2018

Last updated

Sep 3, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Amber Prosser Former name

Medicare fee-for-service enrollment

Enrolled in OK

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ennoble HC NJ PCGroup PAC ID 0345638185, 129 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Ennoble HC NJ PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1306500764

  OK

  Medicare reassignment Care Compare group
• Ennoble HC NJ II PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1871475806

  OK

  Medicare reassignment
• Ennoble HC NJ III PC

  • Geriatric Medicine (Family Medicine) Physician
  • Hackensack, NJ
  • NPI 1043192099

  OK

  Medicare reassignment
• Revive Health of Oklahoma LLC

  dba Revive Health Of Oklahoma

  • General Practice Physician
  • Oklahoma City, OK
  • NPI 1740842327
  NPD (past)
• Vital Systems of Oklahoma Inc

  • Home Infusion Therapy Pharmacy
  • Mustang, OK
  • NPI 1205901964
  NPD (past)

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1144705849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 E HIGHLINE LN",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730646406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3209 S BROADWAY STE 229",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730134064",
            "telephone_number": "551-295-8223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "OK",
            "postal_code": "736012309",
            "country_code": "US",
            "telephone_number": "405-376-9980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "AMBER",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-27",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "F10171219",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "91331",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "PROSSER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kenneth Wayne Elliott, LMFT
• Khyler Elliott, SLPA
• Linda S Elliott, M.S., CCC
• Michael Stephen Elliott, M.D.
• Victoria Elliott
• Jennifer Leanne Ellis
• Quinton Ellis, LPC
• Steven Mark Ellsworth, LADC/MH
• Ayman Elnahry, MD, PHD
• Steven Elrod, MSN, PMHNP-BC

• Family Nurse Practitioner in Edmond, OK
• Providers in Edmond, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; 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.