Colleen Erin Ellis, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704262495 Issued in MI

Practice address

1080 Walloon Way
Lake Orion, MI 48360-1318

Phone

(248) 210-9115

NPI assigned

Jun 3, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cardiovascular Consultants PCGroup PAC ID 9436132131, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
• Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
• Ascension Providence Rochester Hospital Hospital, Rochester, MI, CCN 230254

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8209/brand/5/csg/21/fhir/r4
• Direct secure messaging: cellis1079179@direct.hfhs.org

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.

• Cardiovascular Consultants PC

  • Cardiovascular Disease Physician
  • Sterling Heights, MI
  • NPI 1053368233
  Medicare reassignment Care Compare group NPD
• Henry Ford Health Rochester Hospital

  • Nurse Practitioner
  • Rochester, MI
  • NPI 1427171511
  Medicare reassignment NPD
• Alpha Urgent Care PLLC

  • Health Service Clinic/Center
  • Rochester Hills, MI
  • NPI 1326630716
  Medicare reassignment
• Henry Ford Health Rochester Hospital

  • Family Medicine Physician
  • Rochester, MI
  • NPI 1184747263
  NPD
• Alpha Urgent Care PLLC

  • Health Service Clinic/Center
  • Rochester Hills, MI
  • NPI 1073304416
  NPD (past)
• American Cardiovascular Health, PLC

  • Interventional Cardiology Physician
  • Rochester Hills, MI
  • NPI 1689400194
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Rochester Hospital

  • General Acute Care Hospital
  • Rochester, MI
  • NPI 1437176203
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  dba Henry Ford Health Macomb Hospital

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634
  Care Compare affiliation
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Troy

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1437539681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 W UNIVERSITY DR",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483071863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 WALLOON WAY",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601318",
            "telephone_number": "248-210-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "COLLEEN",
        "middle_name": "ERIN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704262495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Kathleen Edstrom, WHNP
• Pimchanok Ehrmann
• Jordyn Elam
• Elite Endodontics
• Elite Healthcare PLC (Orion Oxford Urgent Care)
• Ava Vincentia Emary
• David E Emeigh, RPH
• Nathan R Emert
• Endometriosis Treatment Center of America - Michigan PLLC (Endometriosis Treatment Center of America)
• Michael Engel, DO

• Family Nurse Practitioner in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.