Individual provider Active NPI

Claire E Ellis, NP

  • Nurse Practitioner
  • New Albany, IN
National Provider Identifier
1740677558
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71005890A Issued in IN
Practice address
4101 Technology Ave
New Albany, IN 47150-8548
Phone
(812) 590-3334
NPI assigned
Apr 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3009301 KY
Family Nurse Practitioner 363LF0000X 71005890A IN
Nurse Practitioner 363L00000X 71005890A IN Primary

Addresses

Primary practice location

4101 Technology Ave
New Albany, IN 47150-8548

Mailing address

PO Box 950248
Louisville, KY 40295-0248
Phone (812) 949-5482

Other identifiers 2

IdentifierTypeStateIssuer
7100374130MedicaidKY
201361760MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151117001655 KY Practitioner - Nurse Practitioner 1557671815 Reassigns benefits to 2 organizations
I20160509000178 IN Practitioner - Nurse Practitioner 1557671815 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, shared by 31 NPIs, 2,431 clinicians

Practice addresses (Care Compare)

1373 E State Rd
Madison, IN 47250-7328
Phone (812) 801-0810

3900 Kresge Way
Suite 56
Louisville, KY 40207-4683
Phone (502) 895-7265

800 Highlander Point Dr
Floyds Knobs, IN 47119-9465

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Nurse Practitioner Current Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner Current Accepting new patients
Baptist Medical Associates Inc CurrentSince May 8, 2017 Accepting new patients
Baptist Health Medical Group Inc Nurse Practitioner CurrentSince May 1, 2017 Accepting new patients
Baptist Health Medical Group Inc CurrentSince May 1, 2017 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner Past Accepting new patients

Locations

7725 Highway 62
Ste 100
Charlestown, IN 47111
Phone (812) 280-0413

2051 Clevidence Blvd
Clarksville, IN 47129
Phone (812) 280-6650

2051 Clevidence Blvd
Ste A
Clarksville, IN 47129
Phone (812) 280-1720

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

3900 Kresge Way
Ste 56
Louisville, KY 40207
Phone (502) 895-7265

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1740677558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950248",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950248",
            "telephone_number": "812-949-5482",
            "fax_number": "812-949-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TECHNOLOGY AVE",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471508548",
            "telephone_number": "812-590-3334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "CLAIRE",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009301",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005890A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71005890A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100374130",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201361760",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.