Active NPI
Kelsey Lynn Ellison
- Family Nurse Practitioner
- College Station, TX
National Provider Identifier
1568002129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 32276
- Practice address
- 311 Houston Street
College Station, TX 77843-0001 - Phone
- (979) 458-8310
- Fax
- (979) 458-8319
- NPI assigned
- Jan 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 882697 | TX | |
| Family Nurse Practitioner | 363LF0000X | 32276 | TX | Primary |
Addresses
Primary practice location
311 Houston Street
College Station, TX 77843-0001
Mailing address
1264 Tamu
College Station, TX 77843-0001
Phone (979) 458-8310
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32276 | TX | MD | General Practice Dentistry |
| 882697 | TX | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1578873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776211200000",
"number": "1568002129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1264 TAMU",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778430001",
"telephone_number": "979-458-8310",
"fax_number": "979-458-8319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 HOUSTON STREET",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778430001",
"telephone_number": "979-458-8310",
"fax_number": "979-458-8319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "KELSEY",
"middle_name": "LYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-01-13",
"last_updated": "2026-04-15",
"certification_date": "2026-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "882697",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "32276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.