NPIMap

Individual provider Active NPI

Luke A Ellerman, CNP

  • Adult Health Nurse Practitioner
  • Quincy, IL
National Provider Identifier
1386206795
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209019664 Issued in IL
Practice address
1025 Maine St
Quincy, IL 62301-4038
Phone
(217) 222-6550
NPI assigned
Jul 5, 2019
Last updated
Jul 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209019664 IL Primary

Addresses

Primary practice location

1025 Maine St
Quincy, IL 62301-4038

Mailing address

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190808000444 IL Practitioner - Nurse Practitioner 8820325244 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

238 S Congress St
Rushville, IL 62681-1465
Phone (217) 322-5296

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209019664ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Schuyler County Hospital District CurrentSince Jul 1, 2022 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Schuyler County Hospital District CurrentSince Jul 1, 2022 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Jul 23, 2019 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Current Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Adult Health CurrentSince Jul 23, 2019 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Past Accepting new patients
Schuiyler County Hospital District Health Center Inc Past Accepting new patients

Locations

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

238 S Congress St
Rushville, IL 62681
Phone (217) 322-4321

Interoperability endpoints

  • Direct secure messaging: lellerman684514@direct.unitypoint.org

Organizations & group practices 8

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 6

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": "1562284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1386206795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERMAN",
        "first_name": "LUKE",
        "middle_name": "A",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-05",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209019664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.