Active NPI
Kerri Lee Ellis, A.R.N.P.
- Family Nurse Practitioner
- Beggs, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 53535
- Practice address
- 103 E Main St
Beggs, OK 74421 - Phone
- (918) 267-7000
- Fax
- (918) 267-7077
- NPI assigned
- Sep 16, 2008
- Last updated
- Sep 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 53535 | OK | Primary |
Addresses
Primary practice location
103 E Main St
Beggs, OK 74421
Mailing address
PO Box 478
103 E Main St
Beggs, OK 74421-0478
Phone (918) 367-0010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of Oklahoma College of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
103 E Main
Beggs, OK 74421
Phone (918) 367-0010
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53535 | OK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinico LLC | Current | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/ADEAED/Endpoint/ADEAED
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Clinico LLC | Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Corporate Director (100%) |
Oct 25, 2001 Oct 25, 2001 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba Clinico Rural Health Clinic
- Rural Health Clinic/Center
- Beggs, OK
- NPI 1497766000
5% Or Greater Direct Ownership Interest, Corporate Director
Organizations & group practices 1
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.
-
- Home Health Agency
- Ada, OK
- NPI 1770638967
-
dba Muscogee (Creek) Nation Long Term Acute Care Hospital
- Long Term Care Hospital
- Okmulgee, OK
- NPI 1376979955
-
dba Muscogee (Creek) Nation Medical Center
- General Acute Care Hospital
- Okmulgee, OK
- NPI 1902236573
-
dba Complete Home Health of Western Oklahoma
- Home Health Agency
- Enid, OK
- NPI 1174519102
-
dba Mays Home Health of Tulsa
- Home Health Agency
- Okmulgee, OK
- NPI 1467956599
-
- Critical Access Hospital
- Sapulpa, OK
- NPI 1922076603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221523200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632960000000",
"number": "1447409206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 478",
"address_2": "103 E MAIN ST",
"city": "BEGGS",
"state": "OK",
"postal_code": "744210478",
"telephone_number": "918-367-0010",
"fax_number": "918-703-4713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 E MAIN ST",
"city": "BEGGS",
"state": "OK",
"postal_code": "74421",
"telephone_number": "918-267-7000",
"fax_number": "918-267-7077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "KERRI",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "A.R.N.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-16",
"last_updated": "2021-09-30",
"certification_date": "2021-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OK",
"license": "53535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beggs, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.