NPIMap

Individual provider Active NPI

Ellen Lavera Qualls, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Cave City, AR
National Provider Identifier
1689819682
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
A03179 Issued in AR
Practice address
301 S Main St Ste D
Cave City, AR 72521-5010
Phone
(870) 834-0581
NPI assigned
Dec 5, 2008
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X A03179 AR Primary
Acute Care Clinical Nurse Specialist 364SA2100X A03179 AR

Addresses

Primary practice location

301 S Main St Ste D
Cave City, AR 72521-5010

Mailing address

301 S Main St Ste D
Cave City, AR 72521-5010
Phone (870) 834-0581

Other identifiers 3

IdentifierTypeStateIssuer
A03179OtherARAPN LICENSE A03179
180502758MedicaidAR
5R233OtherARBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20090211000165 AR Practitioner - Nurse Practitioner 6406911296 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
May accept Medicare assignment
Group practices
White River Health System, Inc.Group PAC ID 0143134270, shared by 36 NPIs, 190 clinicians
Still Waters Wellness LLCGroup PAC ID 2860853751, 2 clinicians

Practice addresses (Care Compare)

16 Hospital Cir
Suite a
Batesville, AR 72501-7343
Phone (870) 793-7519

2200 Malcolm Ave
Suite B
Newport, AR 72112-3697
Phone (870) 512-2500

301 S Main St
Cave City, AR 72521-9476
Phone (870) 283-5353

301 S Main St
Suite D
Cave City, AR 72521-9224
Phone (870) 916-2771

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A03179ARMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Still Waters Wellness LLC Psychiatric/Mental Health CurrentSince Jun 1, 2023 Accepting new patients
White River Health System Inc CurrentSince May 29, 2025 Accepting new patients
White River Health System, Inc. Psychiatric/Mental Health CurrentSince Dec 1, 2021 Accepting new patients
White River Health System, Inc. CurrentSince Mar 1, 2011 Accepting new patients
Jay Jeffrey, MD, Facs, PLLC CurrentSince Mar 23, 2019 Accepting new patients
White River Health System, Inc CurrentSince Mar 1, 2019 Accepting new patients
White River Health System, Inc. CurrentSince Apr 7, 2023 Accepting new patients
Batesville Cardiology PA Past Accepting new patients

Locations

16 Hospital Cir
Batesville, AR 72501

16 Hospital Cir
Ste A
Batesville, AR 72501
Phone (870) 269-4361

1710 Harrison St
Batesville, AR 72501
Phone (870) 262-1240

2230 Harrison St
Batesville, AR 72501
Phone (870) 698-2100

253 Virginia Dr
Batesville, AR 72501
Phone (870) 569-8179

3443 Harrison St
Batesville, AR 72501
Phone (870) 698-1635

301 S Main St
Ste D
Cave City, AR 72521
Phone (501) 270-9503

2200 Malcolm Ave
Ste B
Newport, AR 72112
Phone (870) 512-2500

1217 Batesville Blvd
#F
Southside, AR 72501
Phone (870) 262-2800

Interoperability endpoints

  • Direct secure messaging: ellen.qualls.1@13831.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1689819682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S MAIN ST STE D",
            "city": "CAVE CITY",
            "state": "AR",
            "postal_code": "725215010",
            "telephone_number": "870-834-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S MAIN ST STE D",
            "city": "CAVE CITY",
            "state": "AR",
            "postal_code": "725215010",
            "telephone_number": "870-834-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUALLS",
        "first_name": "ELLEN",
        "middle_name": "LAVERA",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-05",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "A03179",
            "primary": true
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "AR",
            "license": "A03179",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE A03179",
            "identifier": "A03179",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180502758",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5R233",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cave City, AR

Sources for this page

Verify at the official NPI Registry.