Individual provider Active NPI

Ellisa Brianne Cornelius, APRN

  • Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1245118686
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11041237 Issued in FL
Practice address
331 S Florida Ave Ste 201
Lakeland, FL 33801-4626
Phone
(863) 329-2750
NPI assigned
Aug 25, 2025
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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 APRN11041237 FL Primary

Addresses

Primary practice location

331 S Florida Ave Ste 201
Lakeland, FL 33801-4626

Mailing address

3607 Medulla Rd
Plant City, FL 33566-4515
Phone (813) 629-9060

Other practice location 1

3607 Medulla Rd
Plant City, FL 33566-4515
Phone (813) 629-9060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20260204004544 FL Practitioner - Nurse Practitioner 2062991557 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empath Community Health LLCGroup PAC ID 8527368877, 10 clinicians

Practice addresses (Care Compare)

6770 102ND Ave N
Pinellas Park, FL 33782-2909
Phone (727) 523-2460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN11041237FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Empath Hospice, LLC CurrentSince Oct 12, 2025 Accepting new patients
Empath Community Health LLC CurrentSince Dec 31, 2025 Accepting new patients

Locations

331 S Florida Ave
Ste 201
Lakeland, FL 33801
Phone (863) 329-2750

6310 Capital Dr
Lakewood Ranch, FL 34202
Phone (941) 552-7500

6770 102nd Ave N
Pinellas Park, FL 33782
Phone (727) 523-2460

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1756080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1245118686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3607 MEDULLA RD",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335664515",
            "telephone_number": "813-629-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 S FLORIDA AVE STE 201",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014626",
            "telephone_number": "863-329-2750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3607 Medulla Rd",
            "address_purpose": "LOCATION",
            "city": "Plant City",
            "state": "FL",
            "postal_code": "335664515",
            "country_code": "US",
            "telephone_number": "813-629-9060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORNELIUS",
        "first_name": "ELLISA",
        "middle_name": "BRIANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-25",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11041237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.