Donna A Thomas Ellis, CFNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

602612 Issued in MS

Practice address

1040 N Flowood Dr Ste 100
Flowood, MS 39232-9789

Phone

(601) 933-5417

NPI assigned

Dec 4, 2006

Last updated

Mar 24, 2022By 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

Other names 1

• Donna A Thomas Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: donna.thomas.ellis.1@4695.direct.athenahealth.com

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.

• Central Mississippi Civic Improvement Association, Inc

  dba Jackson Hinds Comprehensiv Health Center

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1134151442
  Medicare reassignment NPD
• Central Mississippi Civic Improvement Association, Inc

  dba Jackson Hinds Comprehensive Health Center

  • Federally Qualified Health Center (FQHC)
  • Utica, MS
  • NPI 1700813052
  NPD
• Central Mississippi Civic Improvement Association, Inc.

  dba Jackson Hinds Comprehensive Health Center Unit 7

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1215744396
  NPD
• Central Mississippi Civic Improvement Association, Inc.

  dba Jackson-Hinds Comprehensive Health Center

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1154424554
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1760550990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 321359",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392321359",
            "telephone_number": "601-933-5417",
            "fax_number": "601-936-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 N FLOWOOD DR STE 100",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329789",
            "telephone_number": "601-933-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS ELLIS",
        "first_name": "DONNA",
        "middle_name": "A",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "602612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05457378",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "donna.thomas.ellis.1@4695.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1040 N Flowood Dr Ste 100",
            "city": "Flowood",
            "state": "MS",
            "country_code": "US",
            "postal_code": "392329789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DONNA",
            "last_name": "THOMAS",
            "middle_name": "A",
            "credential": "CFNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Flowood, MS
• Providers in Flowood, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.