Mary Ellis, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

113044 Issued in NE

Practice address

223 E Condron St
Valley, NE 68064-3401

Phone

(402) 517-7646

Fax

(402) 359-2702

NPI assigned

Apr 25, 2014

Last updated

Feb 4, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Enrichment Inc

  • Social Worker
  • Omaha, NE
  • NPI 1164582169

  Single Specialty

  Medicare reassignment NPD
• Methodist Fremont Health

  dba Methodist Fremont Health Professional Services

  • Internal Medicine Physician
  • Fremont, NE
  • NPI 1235618216

  Single Specialty

  Medicare reassignment NPD
• Ellis Psychiatric LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Valley, NE
  • NPI 1649194432
  NPD (past) Authorized official

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1790105948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 E CONDRON ST",
            "city": "VALLEY",
            "state": "NE",
            "postal_code": "680643401",
            "telephone_number": "402-871-6010",
            "fax_number": "402-359-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 E CONDRON ST",
            "city": "VALLEY",
            "state": "NE",
            "postal_code": "680643401",
            "telephone_number": "402-517-7646",
            "fax_number": "402-359-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MARY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NE",
            "license": "113044",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NE",
            "license": "55813",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "113044",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas County Housing Authority (Orchard Gardens)
• Douglas County West Schools
• Down Home Health LLC
• Angela D Duysen
• Ellis Psychiatric LLC
• Stephanie Elise Emig Witt
• Megan Engel, LMHP
• Michelle Grennan
• Carol Hagemann
• Jennifer Hall

• Psychiatric/Mental Health Nurse Practitioner in Valley, NE
• Providers in Valley, NE by specialty
• Psychiatric/Mental Health Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.