Mark D. Ellis, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP108475 Issued in TX

Practice address

208 Haley Rd
Johnson City, TX 78636-4617

Phone

(830) 868-9500

Fax

(830) 868-4606

NPI assigned

Aug 10, 2005

Last updated

Aug 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

University of Texas Medical Branch at Galveston, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Scott and White Hospital - Marble FallsGroup PAC ID 6901117175, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of Marble Falls Home health agency, Marble Falls, TX, CCN 679520
• Baylor Scott & White Medical Center - Marble Falls Hospital, Marble Falls, TX, CCN 670108
• Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054
• Baylor Scott & White Medical Center - Round Rock Hospital, Round Rock, TX, CCN 670034
• Hill Country Memorial Hospital Hospital, Fredericksburg, TX, CCN 450604

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mellis838131@direct.sw.org

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.

• Scott & White Hospital - Marble Falls

  • Internal Medicine Physician
  • Marble Falls, TX
  • NPI 1295397859
  Medicare reassignment Care Compare group
• Ut Physicians

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1033157821
  Medicare reassignment NPD
• Ut Physicians

  dba UT Health Services

  • Health Educator
  • Houston, TX
  • NPI 1316534472
  NPD
• Center for Primary Care Specialists, P.a.

  • Internal Medicine Physician
  • La Marque, TX
  • NPI 1861426033
  NPD (past)
• Llano Regional Hospital

  dba Scott & White Hospital - Llano, Professional Services

  • Family Medicine Physician
  • Llano, TX
  • NPI 1457652745
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Methodist Healthcare System of San Antonio, LTD., L.L.P.

  dba Methodist Hospital Hill Country

  • General Acute Care Hospital
  • Fredericksburg, TX
  • NPI 1376256354
  Care Compare affiliation
• Scott & White Hospital - Marble Falls

  dba Baylor Scott & White Medical Center - Marble Falls

  • General Acute Care Hospital
  • Marble Falls, TX
  • NPI 1396138970
  Care Compare affiliation
• Scott & White Hospital - Round Rock

  dba Baylor Scott & White Medical Center - Round Rock

  • General Acute Care Hospital
  • Round Rock, TX
  • NPI 1265568638
  Care Compare affiliation
• Scott & White Memorial Hospital

  dba Baylor Scott & White Medical Center - Temple

  • General Acute Care Hospital
  • Temple, TX
  • NPI 1477516466
  Care Compare affiliation
• Scott & White Memorial Hospital

  dba Kings's Daughters Hospital- Scott & White Healthcare

  • General Acute Care Hospital
  • Temple, TX
  • NPI 1578502613
  Care Compare affiliation
• Texas Home Health Group of Marble Falls, LLC

  dba AccentCare Home Health of Marble Falls

  • Home Health Agency
  • Marble Falls, TX
  • NPI 1457881807
  Care Compare affiliation

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1508868530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 HALEY RD",
            "city": "JOHNSON CITY",
            "state": "TX",
            "postal_code": "786364617",
            "telephone_number": "830-868-9500",
            "fax_number": "830-868-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MARK",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "609633",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP108475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8N3533",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mellis838131@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "208 Haley Rd",
            "city": "Johnson City",
            "state": "TX",
            "country_code": "US",
            "postal_code": "786364617",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Blanco Regional Clinic (Johnson City Medical Clinic)
• Bruce A. Bottcher, D.C.
• Emily Cropper, PA-C
• Mary Elizabeth Eilers, APN
• Elevate Acupuncture and Wellness, PLLC
• Jovawna Dawn Ellison-Hubbard, MSN,APRN,FNP-BC
• John Phillip Frasure, PA-C
• Mary Kathryn Hagemeier, D.D.S.
• Hamilton County Hospital District (Avir at Johnson City)
• Johnson City Chiropractic LLC (Johnson City Chiropractic)

• Family Nurse Practitioner in Johnson City, TX
• Providers in Johnson City, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.