Individual provider Active NPI

Angela Ellard, APRN-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1558993378
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN.CNP.021512 Issued in OH
Practice address
3406 Erie Ave Ste a
Cincinnati, OH 45208-1741
Phone
(513) 255-5555
NPI assigned
Feb 10, 2020
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X RN.396624 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.021512 OH Primary
Primary Care Nurse Practitioner 363LP2300X APRN.CNP.021512 OH

Addresses

Primary practice location

3406 Erie Ave Ste a
Cincinnati, OH 45208-1741

Mailing address

3406 Erie Ave Ste a
Cincinnati, OH 45208-1741
Phone (513) 255-5555

Other identifiers 1

IdentifierTypeStateIssuer
2910854MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20200401000949 OH Practitioner - Nurse Practitioner 9234568940 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.396624OHMDNursing Care Agency
APRN.CNP.021512OHMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Jan 21, 2025 Accepting new patients
Viaquest Psychiatric & Behavioral Solutions LLC CurrentSince Oct 12, 2022 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

4449 Easton Way
Fl 2
Columbus, OH 43219
Phone (614) 565-8197

525 Metro Pl N
Ste 300
Dublin, OH 43017
Phone (614) 336-9600

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1558993378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3406 ERIE AVE STE A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452081741",
            "telephone_number": "513-255-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 ERIE AVE STE A",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452081741",
            "telephone_number": "513-255-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLARD",
        "first_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "APRN-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "OH",
            "license": "RN.396624",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.021512",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.021512",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.