Individual provider Active NPI

Ellen Talbott, FNP

  • Nurse Practitioner
  • Traverse City, MI
National Provider Identifier
1386231223
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704282876 Issued in MI
Practice address
815 Business Park Dr Ste a
Traverse City, MI 49686-8683
Phone
(231) 421-6921
NPI assigned
Dec 27, 2020
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704282876 MI Primary

Addresses

Primary practice location

815 Business Park Dr Ste a
Traverse City, MI 49686-8683

Mailing address

4700 Park Forest Dr
Suite 208
Traverse City, MI 49684-7041
Phone (231) 935-5710

Other practice location 1

4700 Park Forest Dr
Suite 208
Traverse City, MI 49684
Phone (231) 935-5710

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address ccm@chronic-care.net Direct
Direct Messaging Address ccm@chronic-care.net Direct
Direct Messaging Address ccm@chronic-care.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20201231000706 MI Practitioner - Nurse Practitioner 3173936648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Munson Medical CenterGroup PAC ID 3072426287, 377 clinicians

Practice addresses (Care Compare)

4100 Park Forest Dr
Suite 208
Traverse City, MI 49684-7306
Phone (231) 935-5710

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center Current Accepting new patients
Munson Medical Center CurrentSince Nov 1, 2024 Accepting new patients
Chronic Care Management LLC Nurse Practitioner CurrentSince Dec 1, 2020 Accepting new patients
Munson Medical Center CurrentSince Nov 1, 2024 Accepting new patients
Munson Medical Center Past Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

204 W Buttles St
Midland, MI 48640

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

4020 Copper Vw
Ste 104
Traverse City, MI 49684
Phone (231) 421-6921

4100 Park Forest Dr
Ste 208
Traverse City, MI 49684
Phone (231) 392-8705

810 Business Park Dr
Ste A
Traverse City, MI 49686
Phone (231) 421-6921

815 Business Park Dr
#A
Traverse City, MI 49686
Phone (231) 421-6921

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 3

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": "1609027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1386231223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 PARK FOREST DR",
            "address_2": "SUITE 208",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847041",
            "telephone_number": "231-935-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 BUSINESS PARK DR STE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496868683",
            "telephone_number": "231-421-6921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Park Forest Dr",
            "address_2": "Suite 208",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "49684",
            "country_code": "US",
            "telephone_number": "231-935-5710",
            "fax_number": "231-935-9045",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALBOTT",
        "first_name": "ELLEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-27",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704282876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccm@chronic-care.net",
            "affiliation": "N",
            "endpointDescription": "Chronic Care e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "815 Business Park Dr Ste A",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496868683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccm@chronic-care.net",
            "affiliation": "N",
            "endpointDescription": "Chronic Care e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "810 Business Park Dr Ste A",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496868683",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ccm@chronic-care.net",
            "affiliation": "N",
            "endpointDescription": "Chronic Care e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "e-mail",
            "address_1": "4020 Copper Vw Ste 104",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496847041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.