Merri Doretha Ellison

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP500021596 Issued in DC

Practice address

2350 Washington PL NE
Washington, DC 20018-1070

Phone

(202) 544-7580

NPI assigned

Dec 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL, MS, DC3 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 3

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Mississippi Civic Improvement Association, IncGroup PAC ID 4183533235, 48 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Central Mississippi Civic Improvement Association, Inc

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1134151442
  Medicare reassignment Care Compare group NPD
• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581
  Medicare reassignment NPD
• Franklin Primary Health Center Inc.

  • Federally Qualified Health Center (FQHC)
  • Mobile, AL
  • NPI 1679532303
  Medicare reassignment NPD
• Central Mississippi Civic Improvement Association, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jackson, MS
  • NPI 1215744396
  NPD
• Franklin Primary Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Evergreen, AL
  • NPI 1346733821
  NPD
• Franklin Primary Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Atmore, AL
  • NPI 1912327446
  NPD

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1780987032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70365",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361070365",
            "telephone_number": "334-420-5038",
            "fax_number": "334-420-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 WASHINGTON PL NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200181070",
            "telephone_number": "202-544-7580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 Cherry St",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361072613",
            "country_code": "US",
            "telephone_number": "334-420-5001 x215",
            "fax_number": "334-420-0146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "MERRI",
        "middle_name": "DORETHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1105095",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "NP500021596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis Ellis
• Willie Lee Ellis I
• Vashtina G Ellison-Ruddock, FNP
• Christopher Winston Ellison, PHARM.D.
• Lamont Tairi Ellison
• Rachelle Ellison
• Rashad Ellison
• Eric Ellsworth, MS, MBA
• Kelley Anne Ellsworth, PA-C
• Peter Joseph Ellsworth, PHD

• Family Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Family Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2025; 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.