Summerlyn Ellis

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10022072 Issued in OR

Practice address

1020 SW Indian Ave
Redmond, OR 97756-3037

Phone

(541) 923-6024

NPI assigned

Feb 20, 2024

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 OR

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Pain Solutions of Oregon LLCGroup PAC ID 8123494242, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Advanced Pain Solutions of Oregon LLC

  • Family Nurse Practitioner
  • Redmond, OR
  • NPI 1982323259
  Medicare reassignment Care Compare group NPD
• Central Oregon ENT LLC - Ear Nose Throat and Facial Plastic Surgey

  • Otolaryngology Physician
  • Bend, OR
  • NPI 1902813884
  NPD (past)

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1689439341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 SW INDIAN AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977563037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 SW INDIAN AVE",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977563037",
            "telephone_number": "541-923-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SUMMERLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10022072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan David Keahi Elek, RPH
• Element Chiropractic LLC
• Amber F Elkind, PA-C
• Dionne Elaine Ellerbrook, LPN
• Tyson James Elliott, PHARMACIST
• Kailey Ells, PT, DPT
• Carla Denise Elms, REGISTERED NURSE, BA
• Alison Elsberry, OTR/L
• Amy Ely, CPHT
• Emergence Physical Therapy

• Family Nurse Practitioner in Redmond, OR
• Providers in Redmond, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.