Maryann Ellis

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4038837 Issued in KY

Practice address

45 Scurry Hill Rd
Glasgow, KY 42141-7773

Phone

(270) 270-2337

NPI assigned

May 12, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• One Cross Community, Inc.

  • Federally Qualified Health Center (FQHC)
  • Campbellsville, KY
  • NPI 1447710314
  Medicare reassignment NPD
• One Cross Community, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lebanon, KY
  • NPI 1215404082
  NPD
• One Cross Health Clinic Inc

  • Rural Health Clinic/Center
  • Campbellsville, KY
  • NPI 1942606454
  NPD (past)

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1326838426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SCURRY HILL RD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421417773",
            "telephone_number": "270-270-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 SCURRY HILL RD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421417773",
            "telephone_number": "270-270-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MARYANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "KY",
            "license": "1113609",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4038837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Rene Durkalski, LPCC
• Derek Owen Duvall, APRN
• Natalie Jean Dyer
• Kennedy Eaton, PT, DPT
• George G Elliott, LMFT, LMHC
• Brian Elmlinger, M.D.
• Ely Drugs Inc
• Ely Drugs Inc
• Ely Drugs Inc
• Ely Drugs Inc

• Psychiatric/Mental Health Nurse Practitioner in Glasgow, KY
• Providers in Glasgow, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.