Christine M Ellis, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

103938 Issued in MO

Practice address

400 S Kingshighway Blvd
Dept Emergency Medicine
Saint Louis, MO 63110-1014

Phone

(314) 362-9123

Fax

(314) 747-3338

NPI assigned

Jul 17, 2006

Last updated

Nov 15, 2021By 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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

84.2 of 100Reported as group

Quality

71.6

Promoting interoperability

100

Improvement activities

40

Cost

75.75

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1710905138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S EUCLID AVE",
            "address_2": "CB 8072",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101010",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S KINGSHIGHWAY BLVD",
            "address_2": "DEPT EMERGENCY MEDICINE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101014",
            "telephone_number": "314-362-9123",
            "fax_number": "314-747-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "103938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428999809",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "400 S Kingshighway Blvd",
            "address_2": "Dept Emergency Medicine",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ellis Sleep Center LLC
• Ellis Therapy & Consulting, LLC
• Alysa Gail Ellis, MD
• Andrew James Ellis, M.D.
• Carol A Ellis, RN
• Denise Michele Ellis, P.T.
• Holly Ellis, DDS
• Jabon L Ellis, D.O.
• Kathryn Gail Ellis, MSW
• Katrece Levoy Ellis, CRNA

• Family Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.