Charlotte Gaye Ellis, APRN-BC
Individual provider Active NPI Family Nurse Practitioner · Madisonville, TX
NPI 1316640832 · NPPES record last updated Jan 2, 2025
Key facts
- NPI
- 1316640832
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2022140613 (TX)
- Practice address
- 712 S May St
Madisonville, TX 77864-2564 - Phone
- (936) 348-3418
- NPI assigned
- Mar 23, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Stigler Health and Wellness Center Inc
Practice addresses (Care Compare)
1505 E Main St
Stigler, OK 74462-2914
Phone (800) 640-9741
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in TX, AK, OK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230406002257 | TX | Practitioner - Nurse Practitioner | 2567837487 | Reassigns benefits to 1 organization |
| I20230920004175 | AK | Practitioner - Nurse Practitioner | 2567837487 | Reassigns benefits to 1 organization |
| I20241122001371 | OK | Practitioner - Nurse Practitioner | 2567837487 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2022140613 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Icare Center LLC | Current |
Accepting new patients | |
| Stigler Health and Wellness Center Inc | Current |
Accepting new patients | |
| Cross Road Health Ministries, Inc. | Current |
Accepting new patients | |
| Cross Road Health Ministries, Inc. | Current |
Accepting new patients | |
| Slater-Delk Medical, PLLC | Current |
Accepting new patients | |
| MCH Professional Care | Past | Accepting new patients | |
| Icare Primary & Wellness Clinic LLC | Past | Accepting new patients |
Locations
187 Glenn Hwy
Glennallen, AK 99588
Phone (907) 822-3203
404 W Main St
Davis, OK 73030
Phone (405) 391-5526
404 W Main St
Ste 3
Davis, OK 73030
21001 SE 29th St
Harrah, OK 73045
Phone (405) 391-5526
2903 W Britton Rd
Oklahoma City, OK 73120
Phone (405) 755-8028
1505 E Main St
Stigler, OK 74462
Phone (800) 640-9741
3101 S 27th St
Abilene, TX 79605
Phone (325) 695-5440
4009 Ridgemont Dr
Abilene, TX 79606
Phone (325) 232-8830
2602 S Gregg St
Ste 6
Big Spring, TX 79720
Phone (432) 315-2077
407 Kent St
Midland, TX 79701
Phone (432) 687-2273
4400 N Midland Dr
Ste 406A
Midland, TX 79707
Phone (432) 704-5661
3952 E 42nd St
Ste Z
Odessa, TX 79762
Phone (432) 272-0633
Interoperability endpoints
- cellis776101@direct.ochin.org
- charlotte.ellis.p1@direct.crossroadmc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2022140613 | TX | Yes |
Addresses
Primary practice location
712 S May St
Madisonville, TX 77864-2564
Mailing address
2900 Old Houston Rd
Huntsville, TX 77340-6508
Phone (832) 316-2220
Other practice location 1
315 Prospect Dr
Trinity, TX 75862-6202
Phone (936) 744-1400
Other practice location 2
1000 S Broadway
Hobart, OK 73651-1837
Phone (405) 632-6688
Other providers in Madisonville, TX
- Andrew Burleson
- Laquita Clewis
- Tena Measles Crook
- John Edward Deal
- Darren Glenn Dye
- Mallison Fisher
- Franklin Healthcare of Madisonville, LLC
- Joe W Franklin
- Theresa Fusaro
- Kelle Dawn Harper
All providers in Madisonville, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.