Individual provider Active NPI

Ellyse Lopez Lamont, FNP-C

  • Family Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1326558545
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R131456 Issued in MD
Practice address
186 Eastern Blvd N
Hagerstown, MD 21740-5843
Phone
(301) 302-7837
NPI assigned
Oct 2, 2017
Last updated
May 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X AP135273 TX
Family Nurse Practitioner 363LF0000X AP135273 TX
Family Nurse Practitioner 363LF0000X R131456 MD Primary

Addresses

Primary practice location

186 Eastern Blvd N
Hagerstown, MD 21740-5843

Mailing address

203 Charterhouse St
Falling Waters, WV 25419-1698
Phone (240) 818-7400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240827004458 NC Practitioner - Nurse Practitioner 1850659293 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Texas Tech University Health Science Center School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Med First Immediate Care and Family Practice PAGroup PAC ID 0446332720, 94 clinicians

Practice addresses (Care Compare)

200 Cape Fear Cir
Suite 1
Sneads Ferry, NC 28460-9192
Phone (910) 327-2277

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R131456MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Med First Immediate Care & Family Practice, PA Single Specialty CurrentSince Jul 1, 2024 Accepting new patients
Privia Care Center LLC Single Specialty Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Med First Immediate Care & Family Practice PA Single Specialty PastSince Jul 1, 2024 Accepting new patients

Locations

609 Richlands Hwy
Ste 6
Jacksonville, NC 28540
Phone (910) 455-7888

1616 E Millbrook Rd
Ste 110
Raleigh, NC 27609
Phone (919) 341-4016

200 Cape Fear Cir
Ste 1
Sneads Ferry, NC 28460
Phone (910) 327-2277

5130 Southport Supply Rd SE
Unit 1011
Southport, NC 28461
Phone (910) 269-2053

Interoperability endpoints

  • Direct secure messaging: ellyse.lamont.1@1905.direct.athenahealth.com

Organizations & group practices 5

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": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1326558545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 CHARTERHOUSE ST",
            "city": "FALLING WATERS",
            "state": "WV",
            "postal_code": "254191698",
            "telephone_number": "240-818-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 EASTERN BLVD N",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405843",
            "telephone_number": "301-302-7837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMONT",
        "first_name": "ELLYSE",
        "middle_name": "LOPEZ",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-02",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "AP135273",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP135273",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R131456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.