Individual provider Active NPI

Mishell C Ellis, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Charlottesville, VA
National Provider Identifier
1811325764
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024174257 Issued in VA
Practice address
2335 Seminole LN Ste 200
Charlottesville, VA 22901-8303
Phone
(434) 980-6161
Fax
(434) 972-4283
NPI assigned
Oct 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024174257 VA Primary

Addresses

Primary practice location

2335 Seminole LN Ste 200
Charlottesville, VA 22901-8303

Mailing address

PO Box 749112
Atlanta, GA 30374-9112

Other identifiers 2

IdentifierTypeStateIssuer
0024174257OtherVAVIRGINIA NURSE PRACTITIONER LICENSE
RN234444OtherGASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20170131000804 VA Practitioner - Nurse Practitioner 1658509534 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Colonial Internal Medicine Associates PCGroup PAC ID 6608842521, 18 clinicians
Riverside Physician Services IncGroup PAC ID 5092608448, 793 clinicians

Practice addresses (Care Compare)

125 Olde Greenwich Dr
Suite 300
Fredericksburg, VA 22408-4008
Phone (540) 374-5599

2244 Executive Dr
Hampton, VA 23666-2430
Phone (757) 827-1001

Merit-based Incentive Payment System (MIPS)

Final score
94.91 of 100Reported as apm
Quality
92.86
Promoting interoperability
94.93
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince Jul 24, 2023 Accepting new patients
Riverside Physician Services, Inc. CurrentSince Jul 24, 2023 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
University of Virginia Physicians Group CurrentSince Jun 11, 2026 Accepting new patients
Colonial Internal Medicine Associates PC CurrentSince Aug 15, 2024 Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Locations

2335 Seminole Ln
Ste 200
Charlottesville, VA 22901
Phone (434) 975-7700

125 Olde Greenwich Dr
Ste 300
Fredericksburg, VA 22408
Phone (540) 374-5599

2244 Executive Dr
Hampton, VA 23666
Phone (757) 827-1001

858 J Clyde Morris Blvd
Newport News, VA 23601
Phone (757) 594-4343

856 J Clyde Morris Blvd
Ste A
Newport News, VA 23601
Phone (757) 316-5900

392 Garrisonville Rd
Ste 106
Stafford, VA 22554
Phone (540) 374-5599

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1811325764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 SEMINOLE LN STE 200",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229018303",
            "telephone_number": "434-980-6161",
            "fax_number": "434-972-4283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MISHELL",
        "middle_name": "C",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-30",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024174257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA NURSE PRACTITIONER LICENSE",
            "identifier": "0024174257",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "RN234444",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.