Individual provider Active NPI

Ellen Mitchell, RN, BC, FNP,ANP,MSN

  • Nurse Practitioner
  • Alice, TX
National Provider Identifier
1194742726
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
250171 Issued in TX
Practice address
2500 E Main St
Alice, TX 78332-4169
Phone
(361) 661-8000
NPI assigned
Jul 17, 2006
Last updated
Feb 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 250171 TX Primary

Addresses

Primary practice location

2500 E Main St
Alice, TX 78332-4169

Mailing address

PO Box 849881
Dallas, TX 75284-0001
Phone (866) 916-5259

Other identifiers 1

IdentifierTypeStateIssuer
113203704MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20050331000879 TX Practitioner - Nurse Practitioner 2668429754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
74.77 of 100Reported as group
Quality
51.47
Promoting interoperability
88
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
250171TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Dermatology PLLC CurrentSince Nov 15, 2013 Accepting new patients
Delmar Emergency Physicians, LLP Nurse Practitioner Past Accepting new patients
Bayside Emergency Pyhsicians, LLP Nurse Practitioner Past Accepting new patients
Emcare-Dtxemergency Physicians PLLC Nurse Practitioner Past Accepting new patients
Bayside Emergency Physicians, LLP Nurse Practitioner Past Accepting new patients
Abk Emergency Physicians PLLC Nurse Practitioner Past Accepting new patients
Bayside Emergency Physicians, LLP Nurse Practitioner Past Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients

Locations

4141 S Staples St
Ste 300
Corpus Christi, TX 78411
Phone (361) 882-5560

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1194742726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849881",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840001",
            "telephone_number": "866-916-5259",
            "fax_number": "231-922-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E MAIN ST",
            "city": "ALICE",
            "state": "TX",
            "postal_code": "783324169",
            "telephone_number": "361-661-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "ELLEN",
        "credential": "RN, BC, FNP,ANP,MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "250171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113203704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alice, TX

Sources for this page

Verify at the official NPI Registry.