Karrie L Ellis, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

001155 Issued in CT

Practice address

1680 Albany Ave
Hartford, CT 06105

Phone

(860) 236-4511

Fax

(860) 231-8449

NPI assigned

Jun 20, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Village for Families & Children, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Hartford, CT
  • NPI 1841362795
  NPD
• Intercommunity, Inc.

  • Primary Care Clinic/Center
  • East Hartford, CT
  • NPI 1073548533
  NPD (past)
• Intercommunity, Inc.

  • Federally Qualified Health Center (FQHC)
  • East Hartford, CT
  • NPI 1962896548
  NPD (past)
• Medoptions Behavioral Health Assoc, LLC

  • Nurse Practitioner
  • Old Saybrook, CT
  • NPI 1588604060
  NPD (past)

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329091200000",
    "number": "1487690418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061051001",
            "telephone_number": "860-236-4511",
            "fax_number": "860-231-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 ALBANY AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "06105",
            "telephone_number": "860-236-4511",
            "fax_number": "860-231-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KARRIE",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-20",
        "last_updated": "2012-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "001155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2111440",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth, APRN
• Justin Ellenberg, MD
• Kenneth Elligers, MD
• Ahmad Elliott
• Roxann Marie Ellis-Denby, LCSW
• Kimberly E. Ellis, PA-C
• Maria Ellis, MD
• Matthew Ellis, CRNA
• Scott Ellner, DO
• Matthew Griswold Ely III, MD

• Nurse Practitioner in Hartford, CT
• Providers in Hartford, CT by specialty
• Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.