Monica Nicole Ellis, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

905990 Issued in MS

Practice address

402 Wesley Ave Ste 200
Jackson, MS 39202-1000

Phone

(601) 835-5951

NPI assigned

Sep 6, 2023

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 MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Balance Behavioral Health

  • Psychiatry Physician
  • Jackson, MS
  • NPI 1255818076
  Medicare reassignment NPD

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1437935251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 WESLEY AVE",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021000",
            "telephone_number": "769-777-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 WESLEY AVE STE 200",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392021000",
            "telephone_number": "601-835-5951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "604 Highway 80 W",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "MS",
            "postal_code": "390564108",
            "country_code": "US",
            "telephone_number": "601-473-2106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MONICA",
        "middle_name": "NICOLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "905990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parker Steven Elliott
• Andrea Ellis
• Christopher Robert Ellis
• Danielle Hodges Ellis, MD
• Melanie W. Ellis, RNC-NIC, NNP-BC
• Nakesia Ellis, MSN, PMHNP-BC
• Patrice Ellis
• Robin McCaskill Ellis, CRNA
• Dawn Minyard Ellison, LPC
• Francessa Ellison

• Psychiatric/Mental Health Nurse Practitioner in Jackson, MS
• Providers in Jackson, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.