Mary Ellen Anderson, NP
Individual provider Active NPI Family Nurse Practitioner · Owensboro, KY
NPI 1598865347 · NPPES record last updated Sep 9, 2022
Key facts
- NPI
- 1598865347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3004690 (KY)
- Practice address
- 1201 Pleasant Valley Rd
Owensboro, KY 42303-9811 - Phone
- (270) 417-5911
- Fax
- (270) 417-6497
- NPI assigned
- Sep 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Urgent Care Services Southeast PSC
Practice addresses (Care Compare)
310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300
Phone (270) 651-1111
Hospital & facility affiliations
- T J Samson Community Hospital
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 |
|---|---|---|---|---|
| I20121017000813 | KY | Practitioner - Nurse Practitioner | 1355591926 | Reassigns benefits to 7 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4690P | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kentucky Em-I Medical Services PSC | Nurse Practitioner | Current |
Accepting new patients |
| Owensboro Health Medical Group Inc | Current |
Accepting new patients | |
| Owensboro Health Medical Group Inc | Family | Current |
Accepting new patients |
| Owensboro Health Medical Group Inc | Current | Accepting new patients | |
| Southeastern Emergency Physicians LLC | Nurse Practitioner | Current |
Accepting new patients |
| Kentucky Em-I Medical Services PSC | Nurse Practitioner | Current |
Accepting new patients |
| Southeastern Emergency Services P C | Nurse Practitioner | Current |
Accepting new patients |
| Urgent Care Services Southeast PSC | Nurse Practitioner | Current |
Accepting new patients |
| Community Emergency Physicians, PLLC | Past | Accepting new patients |
Locations
1801 Ashley Cir
Bowling Green, KY 42104
Phone (270) 781-4330
1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561
1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521
310 N L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 651-1111
1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141
60 Mercy Ct
Irvine, KY 40336
Phone (606) 723-2115
910 Wallace Ave
Leitchfield, KY 42754
Phone (270) 259-3035
310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612
150 N Eagle Creek Dr
Lexington, KY 40509
Phone (859) 267-9773
803 Poplar St
Murray, KY 42071
Phone (270) 762-1155
1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000
2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352
2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4690P | KY | |
| Family Nurse Practitioner | 363LF0000X | 3004690 | KY | Yes |
Addresses
Primary practice location
1201 Pleasant Valley Rd
Owensboro, KY 42303-9811
Mailing address
104 Raintree PL
Glasgow, KY 42141-2244
Phone (818) 462-0990
Other practice location 1
197 Will Walker Rd
Columbia, KY 42728-7436
Phone (270) 384-9981
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000845568 | Other | KY | ANTHEM |
| P01351973 | Other | KY | RR MEDICARE |
| 7100235010 | Medicaid | KY |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | manderson110641@direct.owensborohealth.org |
Other providers in Owensboro, KY
- Jin S. Amon
- Amy S Carrico DMD PLLC
- Robert Dan Andersen
- Heather Marie Anderson
- Lauren Anderson
- Melanie Anderson
- Amanda Jane Andrew Brown
- Anesthesiology Medical Services PSC
- Michael Anno
- Anthony W Durall DMD PSC
All providers in Owensboro, KY · Family 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 Sep 9, 2022. 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.