NPIMap

Individual provider Active NPI

Ann Christy Elliott-Gonzalez, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1629074372
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3003190 Issued in KY
Practice address
2215 Portland Ave
Louisville, KY 40212
Phone
(502) 774-8631
Fax
(502) 776-8912
NPI assigned
Jun 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3003190 KY Primary

Addresses

Primary practice location

2215 Portland Ave
Louisville, KY 40212

Mailing address

PO Box 950244
Louisville, KY 40295-0244
Phone (502) 953-4700

Other practice location 1

2215 Portland Ave
Louisville, KY 40212-1033
Phone (502) 774-8631

Other identifiers 1

IdentifierTypeStateIssuer
78009511MedicaidKY

Other names 1

  • Ann Christy Elliott Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081204000965 KY Practitioner - Nurse Practitioner 6709947013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health Centers IncGroup PAC ID 6901700053, 51 clinicians

Practice addresses (Care Compare)

4615 Taylor Blvd
Louisville, KY 40215-2307
Phone (502) 953-4700

4803 Southside Dr
Louisville, KY 40214-2111
Phone (502) 363-8606

4805 Southside Dr
Louisville, KY 40214-2111
Phone (502) 772-8860

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088
  • UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Hospital, Louisville, KY, CCN 180040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3003190KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. Current Accepting new patients
Family Health Centers, Inc. CurrentSince Nov 13, 2010 Accepting new patients
Family Health Centers, Inc. CurrentSince Nov 13, 2010 Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers Inc Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients
Family Health Centers, Inc. Past Accepting new patients

Locations

1000 Neighborhood Pl
Fairdale, KY 40118
Phone (502) 361-2381

2500 W Market St
Louisville, KY 40212
Phone (502) 778-0084

4805 Southside Dr
Louisville, KY 40214
Phone (502) 772-8860

120 W Broadway
Louisville, KY 40202
Phone (502) 772-8662

4803 Southside Dr
Louisville, KY 40214
Phone (502) 363-8606

2215 Portland Ave
Louisville, KY 40212
Phone (502) 774-8631

834 E Broadway
Louisville, KY 40204
Phone (502) 583-1981

712 E Muhammad Ali Blvd
Louisville, KY 40202
Phone (502) 568-6972

4112 Taylor Blvd
Louisville, KY 40215
Phone (502) 366-4747

4100 Taylor Blvd
Louisville, KY 40215
Phone (502) 361-2381

4615 Taylor Blvd
Louisville, KY 40215
Phone (502) 366-4747

Interoperability endpoints

  • Direct secure messaging: ann.gonzalez@fhci.eclinicaldirectplus.com

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1629074372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950244",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950244",
            "telephone_number": "502-953-4700",
            "fax_number": "502-772-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 PORTLAND AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40212",
            "telephone_number": "502-774-8631",
            "fax_number": "502-776-8912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402121033",
            "country_code": "US",
            "telephone_number": "502-774-8631",
            "fax_number": "502-776-8912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT-GONZALEZ",
        "first_name": "ANN",
        "middle_name": "CHRISTY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3003190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78009511",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "ELLIOTT",
            "middle_name": "CHRISTY",
            "credential": "APRN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.