Active NPI
Jessica Ann Ellis, C.N.M
- Advanced Practice Midwife
- Helena, MT
National Provider Identifier
1831497353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- Practice address
- 2525 E Broadway St
Ste 204
Helena, MT 59601-8049 - Phone
- (406) 457-4366
- Fax
- (406) 457-4367
- NPI assigned
- Mar 8, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | |||
| Advanced Practice Midwife | 367A00000X | Primary |
Addresses
Primary practice location
2525 E Broadway St
Ste 204
Helena, MT 59601-8049
Mailing address
227 Riverstone Dr
Canton, GA 30114-5256
Phone (770) 720-7733
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 326666 | Other | GA | GEORGIA LICENSE |
| 39957 | Other | MT | STATE LICENSE NUMBER |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jellis16209@direct.med.utah.edu | Direct | University of Utah |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients | |
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| University of Utah Adult Services | Current | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
201 W Layton Pkwy
Ste 2B
Layton, UT 84041
Phone (801) 543-6850
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
Interoperability endpoints
- jellis16209@direct.med.utah.edu
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.
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-
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- NPI 1114321981
-
- Allergy & Immunology Physician
- Taylorsville, UT
- NPI 1710384367
-
- Psychiatry Physician
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- NPI 1023843844
-
- Neurology Physician
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-
- Diagnostic Radiology Physician
- Salt Lake City, UT
- NPI 1598169419
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634774400000",
"number": "1831497353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 RIVERSTONE DR",
"city": "CANTON",
"state": "GA",
"postal_code": "301145256",
"telephone_number": "770-720-7733",
"fax_number": "678-493-9875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 E BROADWAY ST",
"address_2": "STE 204",
"city": "HELENA",
"state": "MT",
"postal_code": "596018049",
"telephone_number": "406-457-4366",
"fax_number": "406-457-4367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIS",
"first_name": "JESSICA",
"middle_name": "ANN",
"credential": "C.N.M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-08",
"last_updated": "2021-10-21",
"certification_date": "2021-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": null,
"license": null,
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEORGIA LICENSE",
"identifier": "326666",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "39957",
"state": "MT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jellis16209@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Helena, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.