Alice C Ellermets, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1802 S Mattis Ave
Champaign, IL 61821-5923

Phone

(217) 383-1850

Fax

(217) 383-3439

NPI assigned

Jul 31, 2019

Last updated

Mar 9, 2023By 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 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1699329268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 S MATTIS AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618215923",
            "telephone_number": "217-383-1850",
            "fax_number": "217-383-3439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 N Main St",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625231206",
            "country_code": "US",
            "telephone_number": "217-362-6262 x4776",
            "fax_number": "217-362-6290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLERMETS",
        "first_name": "ALICE",
        "middle_name": "C",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "150-103578",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agreen@heritagenet.org",
            "affiliation": "N",
            "address_1": "151 N Main St",
            "city": "Decatur",
            "state": "IL",
            "country_code": "US",
            "postal_code": "625231206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Markus Paul Eldred, DDS
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• Elite Care Providers PC
• Elite Spine and Regenerative Pain Center, LTD
• Ellacrit LLC
• Valerie Shae Ellington, LCSW
• Lisa Annette Ellingwood, APRN, PMHNP-BC
• Kevin Joseph Elliott
• Kevin Leslei Elliott, LCPC
• Lisa A Ellis

• Clinical Social Worker in Champaign, IL
• Providers in Champaign, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.