Individual provider Active NPI

Courtney L Ellis, CNM, APRN

  • Advanced Practice Midwife
  • Lexington, KY
National Provider Identifier
1417664863
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
3018639 Issued in KY
Practice address
1720 Nicholasville Rd Ste 702
Lexington, KY 40503-1489
Phone
(859) 264-8811
Fax
(859) 264-8822
NPI assigned
Nov 3, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 3018639 KY Primary

Addresses

Primary practice location

1720 Nicholasville Rd Ste 702
Lexington, KY 40503-1489

Mailing address

PO Box 772437
Detroit, MI 48277-2437
Phone (173) 575-7304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230314001214 KY Practitioner - Certified Nurse Midwife (CNM) 4587038567 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2800 Breckenridge LN
Suite 400
Louisville, KY 40220-1402
Phone (502) 895-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3018639KYMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Oct 9, 2023 Accepting new patients
Baptist Medical Associates Inc CurrentSince Oct 9, 2023 Accepting new patients
Baptist Health Medical Group Inc Past Accepting new patients

Locations

1775 Alysheba Way
Ste 180
Lexington, KY 40509
Phone (859) 240-2109

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

4001 Kresge Way
Ste 134
Louisville, KY 40207
Phone (502) 893-6777

2800 Breckenridge Ln
Ste 400
Louisville, KY 40220
Phone (502) 895-1111

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1417664863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772437",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482772437",
            "telephone_number": "173-575-7304",
            "fax_number": "317-575-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 NICHOLASVILLE RD STE 702",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031489",
            "telephone_number": "859-264-8811",
            "fax_number": "859-264-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "COURTNEY",
        "middle_name": "L",
        "credential": "CNM, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-03",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "KY",
            "license": "3018639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.