Bevin Lyle Ellenberg, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-140234 Issued in AL

Practice address

3500 Highway 78 E Ste a
Jasper, AL 35501-8908

Phone

(205) 387-0333

Fax

(256) 534-2605

NPI assigned

Aug 21, 2017

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

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Oncology Specialties, P.C.Group PAC ID 1254328495, 108 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Walker Baptist Medical Center Hospital, Jasper, AL, CCN 010089

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse, Nurse Practitioner

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 and National Provider Directory roles.

• Oncology Specialties, P.C.

  • Hematology & Oncology Physician
  • Huntsville, AL
  • NPI 1669425716
  Medicare reassignment Care Compare group NPD

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

• BBH WBMC, LLC

  • General Acute Care Hospital
  • Jasper, AL
  • NPI 1932553385
  Care Compare affiliation

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1780100776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18428",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358048428",
            "telephone_number": "256-705-4224",
            "fax_number": "256-705-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 HIGHWAY 78 E STE A",
            "city": "JASPER",
            "state": "AL",
            "postal_code": "355018908",
            "telephone_number": "205-387-0333",
            "fax_number": "256-534-2605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENBERG",
        "first_name": "BEVIN",
        "middle_name": "LYLE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-140234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eat. Talk. Play. Therapy
• Jonthan Kyle Eaton, D.C.
• Stanton Clay Eggers, DDS
• Emma Grace Ellard
• Ellavating You
• Tammy Alleen Ellis, CCC-A
• Summer Estavan, BS
• Teresa Estes, MS
• Bobby Neil Evans
• Christy Bradberry Evans, PT

• Nurse Practitioner in Jasper, AL
• Providers in Jasper, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.