Carolyn Ann Ellsworth, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

102421 Issued in MO

Practice address

312 N Kentucky St
West Plains, MO 65775-2073

Phone

(417) 257-7076

Fax

(417) 257-1417

NPI assigned

Jul 6, 2005

Last updated

Nov 1, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carolynellsworth@omcmo.allscriptsdirect.net
• Direct secure messaging: dr.ellsworth@mhccaremail.com

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.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  Medicare reassignment NPD
• Ozarks Medical Center

  • Psychiatric Hospital Unit
  • West Plains, MO
  • NPI 1235929027
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare Family Care

  • Family Medicine Physician
  • West Plains, MO
  • NPI 1285801696
  NPD (past)

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1679570618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 N KENTUCKY ST",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752073",
            "telephone_number": "417-257-7076",
            "fax_number": "417-257-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 N KENTUCKY ST",
            "city": "WEST PLAINS",
            "state": "MO",
            "postal_code": "657752073",
            "telephone_number": "417-257-7076",
            "fax_number": "417-257-1417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-06",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MO",
            "license": "102421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Eidson, PT, DPT
• Audrey Clae Eldringhoff, FNP-BC
• Elite Chiropractic of the Ozarks, LLC
• Emily Elliott
• Trease P Ellison
• Empower Therapy Services, LLC
• Empowerme Rehabilitation Missouri LLC
• Maria Eskandar, MSN, APRN, FNP-C
• Michael Eskew, DPT
• Ada R Evans, MSW

• Pediatric Adolescent Medicine Physician in West Plains, MO
• Providers in West Plains, MO by specialty
• Pediatric Adolescent Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.