Autumn Denise Ellis, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

29129 Issued in TN

Practice address

320 S Church St
Halls, TN 38040-1510

Phone

(731) 836-9303

NPI assigned

Mar 19, 2021

Last updated

Mar 19, 2021By 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

Medicare fee-for-service enrollment

Enrolled in TN

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WT Medical AssociatesGroup PAC ID 1951650613, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health Care Home health agency, Jackson, TN, CCN 447278
• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
• Dyersburg Regional Medical Center Hospital, Dyersburg, TN, CCN 440072

Merit-based Incentive Payment System (MIPS)

Final score

95.74 of 100Reported as apm

Quality

85.23

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aellis18981@directepic.wth.org

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.

• WT Medical Associates

  • Internal Medicine Physician
  • Dyersburg, TN
  • NPI 1295223279

  Family

  Medicare reassignment Care Compare group NPD
• WT Medical Associates

  dba West Tennessee Medical Group Primary Care Halls

  • Rural Health Clinic/Center
  • Halls, TN
  • NPI 1356176556
  NPD

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

• Dyersburg Health

  dba Dyersburg Employee Pharmacy

  • Community/Retail Pharmacy
  • Dyersburg, TN
  • NPI 1043282338

  Hospital

  Care Compare affiliation
• HHC, LLC

  dba Amedisys Home Health Care

  • Home Health Agency
  • Jackson, TN
  • NPI 1851349559
  Care Compare affiliation
• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation

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

{
    "created_epoch": "1616112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1194301242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3189 GARRETT BALL RD",
            "city": "GATES",
            "state": "TN",
            "postal_code": "380375206",
            "telephone_number": "731-694-2872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S CHURCH ST",
            "city": "HALLS",
            "state": "TN",
            "postal_code": "380401510",
            "telephone_number": "731-836-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "AUTUMN",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-19",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "29129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Rebecca Atchison, FNP
• Aubree Brewster
• Care Rite, PLLC
• Denese Michelle Gooch, LPN
• Halls Family Walk-in Clinic, LLC
• Jeffrey Steven Hampton, FNP
• Brooklyn Rae Mayfield
• Jennifer Wright McWilliams, ACNP

• Family Nurse Practitioner in Halls, TN
• Providers in Halls, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2021; 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.