Catherine Nicole Ellis, APRN
Individual provider Active NPI Nurse Practitioner · Alexandria, KY
NPI 1487056974 · NPPES record last updated Aug 12, 2024
Key facts
- NPI
- 1487056974
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 3008943 (KY)
- Practice address
- 300 Commercial Circle
Alexandria, KY 41001-2107 - Phone
- (859) 635-9440
- Fax
- (859) 448-2622
- NPI assigned
- Sep 16, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Summit Medical Group Inc
Practice addresses (Care Compare)
300 Commerical Circle
Alexandria, KY 41001-0001
Phone (859) 635-9440
Hospital & facility affiliations
- St Elizabeth Edgewood
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150810000301 | KY | Practitioner - Nurse Practitioner | 5294957676 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3008943 | KY | MD | Nurse Practitioner |
| 16513 | OH | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, Inc. | Current |
Accepting new patients | |
| Summit Medical Group, Inc | Nurse Practitioner | Current |
Accepting new patients |
| Summit Medical Group, Inc | Nurse Practitioner | Current | Accepting new patients |
Locations
300 Commercial Dr
Alexandria, KY 41001
Phone (859) 344-5481
405 Violet Rd
Crittenden, KY 41030
Phone (859) 428-1610
20 Medical Village Dr
Ste 258
Edgewood, KY 41017
Phone (606) 341-2666
4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200
7370 Turfway Rd
Ste 290
Florence, KY 41042
Phone (330) 637-0348
1980 Litton Ln
Hebron, KY 41048
Phone (859) 334-8700
1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070
300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217
Interoperability endpoints
- cellis28060@direct-prd.stelizabeth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3008943 | KY | |
| Family Nurse Practitioner | 363LF0000X | 16513 | OH | |
| Nurse Practitioner | 363L00000X | 3008943 | KY | Yes |
Addresses
Primary practice location
300 Commercial Circle
Alexandria, KY 41001-2107
Mailing address
PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 344-5555
Other practice location 1
215 E 11th St
Newport, KY 41071-2203
Phone (859) 655-6100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100321330 | Medicaid | KY |
Other providers in Alexandria, KY
- Kristen Harrell Cummins
- Christen Davis
- Derek M Demaison
- Phillip D Dennis
- Derek Downing
- Julie Lynn Enzweiler
- James Maxwell Ernst
- Amy Farris
- Rhiannon Marie Feltner
- Julie Flora
All providers in Alexandria, KY · Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.