Andrea Lee Ellison, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP2151372 Issued in FL

Practice address

5500 Stadium Pkwy Ste 101
Melbourne, FL 32940-8095

Phone

(321) 306-5510

NPI assigned

Aug 13, 2012

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 FL

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medfast Urgent Care Centers LLCGroup PAC ID 1052418837, 73 clinicians

Practice addresses (Care Compare)

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.

• Medfast Urgent Care Centers LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
  • NPI 1285735605
  Medicare reassignment Care Compare group NPD
• Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Sebastian, FL
  • NPI 1376421479
  NPD

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

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1447507181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 STADIUM PKWY",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408422",
            "telephone_number": "321-306-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 STADIUM PKWY STE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408095",
            "telephone_number": "321-306-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "ANDREA",
        "middle_name": "LEE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP2151372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Ellefson
• Denise Elliott, RN CRNI
• Mary Catherine Elliott, MD
• Petra Gabriele Elliott, MS
• Tiffany M Ellis, M.D.
• Samanta Elmer
• Amber Elmore, APRN
• Richard T Elmore Jr., PHD
• Michael Kyle Ely
• Louis John Emen, PTA

• Family Nurse Practitioner in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2023; 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.