Individual provider Active NPI

Christy Renee Elliott, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Williamsburg, KY
National Provider Identifier
1275247306
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
34175 Issued in KY
Practice address
402 Cumberland Ave
Williamsburg, KY 40769-1238
Phone
(606) 549-2656
NPI assigned
Jan 12, 2023
Last updated
Jul 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 34175 KY Primary
Medical-Surgical Registered Nurse 163WM0705X 1099206 KY

Addresses

Primary practice location

402 Cumberland Ave
Williamsburg, KY 40769-1238

Mailing address

107 S Main St
Jellico, TN 37762-2154
Phone (423) 784-8492

Other practice location 1

173 Browns Creek Rd
Williamsburg, KY 40769-9242
Phone (423) 494-7303

Other practice location 2

550 Sunset Trl
Jellico, TN 37762-2343
Phone (423) 784-5771

Other identifiers 2

IdentifierTypeStateIssuer
4004534OtherKYKY LICENSE
7100905220MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230808001161 TN Practitioner - Nurse Practitioner 3375905367 Reassigns benefits to 1 organization
I20230911003740 KY Practitioner - Nurse Practitioner 3375905367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayspring Health IncGroup PAC ID 7214990746, shared by 4 NPIs, 17 clinicians

Practice addresses (Care Compare)

402 Cumberland Ave
Williamsburg, KY 40769-1238
Phone (423) 784-5771

550 Sunset TRL
Jellico, TN 37762-2343
Phone (423) 784-5771

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1099206KYMDMedical-Surgical Registered Nurse
34175KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dayspring Health Inc Current Accepting new patients
Dayspring Health, Inc. CurrentSince Jul 26, 2023 Accepting new patients
Dayspring Health, Inc. CurrentSince Jul 26, 2023 Accepting new patients
Dayspring Health Inc CurrentSince Jul 26, 2023 Accepting new patients

Locations

1047 S Highway 25 W
Williamsburg, KY 40769
Phone (606) 549-0449

402 Cumberland Ave
Williamsburg, KY 40769
Phone (423) 784-5771

5663 Highway 90
Clairfield, TN 37715
Phone (423) 784-5771

107 S Main St
Jellico, TN 37762
Phone (423) 784-8492

Organizations & group practices 4

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": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1275247306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S MAIN ST",
            "city": "JELLICO",
            "state": "TN",
            "postal_code": "377622154",
            "telephone_number": "423-784-8492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 CUMBERLAND AVE",
            "city": "WILLIAMSBURG",
            "state": "KY",
            "postal_code": "407691238",
            "telephone_number": "606-549-2656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "173 Browns Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Williamsburg",
            "state": "KY",
            "postal_code": "407699242",
            "country_code": "US",
            "telephone_number": "423-494-7303",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 Sunset Trl",
            "address_purpose": "LOCATION",
            "city": "Jellico",
            "state": "TN",
            "postal_code": "377622343",
            "country_code": "US",
            "telephone_number": "423-784-5771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CHRISTY",
        "middle_name": "RENEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "34175",
            "primary": true
        },
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "KY",
            "license": "1099206",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY LICENSE",
            "identifier": "4004534",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100905220",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsburg, KY

Sources for this page

Verify at the official NPI Registry.