Individual provider Active NPI

Ellen M McCollum, CRNP

  • Family Nurse Practitioner
  • Mechanicsburg, PA
National Provider Identifier
1780191155
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP018405 Issued in PA
Practice address
2005 Technology Pkwy Ste 440
Mechanicsburg, PA 17050
Phone
(717) 791-2540
Fax
(717) 791-2549
NPI assigned
Jan 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP018405 PA Primary

Addresses

Primary practice location

2005 Technology Pkwy Ste 440
Mechanicsburg, PA 17050

Mailing address

409 S 2ND St Ste 2F
Harrisburg, PA 17104-1612
Phone (717) 791-2540

Other identifiers 1

IdentifierTypeStateIssuer
103473515MedicaidPA

Other names 1

  • Mrs. Ellen M McCollum Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address emccollum64892@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20180305000592 PA Practitioner - Nurse Practitioner 8123389319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

2005 Technology Pkwy
Suite 440
Mechanicsburg, PA 17050-9413
Phone (717) 791-2540

Hospital & facility affiliations

  • Upmc Pinnacle Hospitals Hospital, Harrisburg, PA, CCN 390067

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP018405PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Feb 1, 2018 Accepting new patients
Pinnacle Health Medical Services CurrentSince Feb 1, 2018 Accepting new patients
Pinnacle Health Medical Services Current Accepting new patients

Locations

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

900 Bryan St
Ste 4
Huntingdon, PA 16652
Phone (814) 643-8424

2005 Technology Pkwy
Ste 440
Mechanicsburg, PA 17050
Phone (717) 614-4420

Interoperability endpoints

  • Direct secure messaging: emccollum295980@upmc.direct-ci.com

Organizations & group practices 3

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 7

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": "1515196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1780191155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 S 2ND ST STE 2F",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171041612",
            "telephone_number": "717-791-2540",
            "fax_number": "717-791-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 TECHNOLOGY PKWY STE 440",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "17050",
            "telephone_number": "717-791-2540",
            "fax_number": "717-791-2549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLUM",
        "first_name": "ELLEN",
        "middle_name": "M",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-06",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103473515",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emccollum64892@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "2005 Technology Pkwy Ste 440",
            "city": "Mechanicsburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "17050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "MCCOLLUM",
            "middle_name": "M",
            "prefix": "MRS.",
            "credential": "ELLEN M. PLANT, R.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mechanicsburg, PA

Sources for this page

Verify at the official NPI Registry.