Individual provider Active NPI

Kimberly Ellis, CRNP

  • Acute Care Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1841564481
Registry record updated Jan 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-092883 Issued in AL
Practice address
1 Hospital Dr SW Ste 100
Huntsville, AL 35801-3495
Phone
(256) 319-5400
Fax
(256) 327-5977
NPI assigned
Feb 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-092883 AL Primary

Addresses

Primary practice location

1 Hospital Dr SW Ste 100
Huntsville, AL 35801-3495

Mailing address

PO Box 18428
Huntsville, AL 35804-8428
Phone (256) 705-4224

Other practice location 1

3601 Cci Dr NW Ste 10
Huntsville, AL 35805-2609
Phone (256) 319-5400

Other practice location 2

201 Sivley Rd SW Ste 10
Huntsville, AL 35801-5138
Phone (256) 319-5400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20120531000552 AL Practitioner - Nurse Practitioner 9032372099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oncology Specialties, P.C.Group PAC ID 1254328495, 108 clinicians

Practice addresses (Care Compare)

1 Hospital Dr SW
Suite 100
Huntsville, AL 35801-3495
Phone (256) 319-5400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-092883ALMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Cancer Care LLC CurrentSince Apr 3, 2012 Accepting new patients
Center for Cancer Care LLC Past Accepting new patients
Center for Cancer Care LLC Past Accepting new patients

Locations

3601 Cci Dr NW
Ste 10
Huntsville, AL 35805
Phone (256) 319-5400

201 Sivley Rd SW
Ste 10
Huntsville, AL 35801
Phone (256) 319-5400

1 Hospital Dr SW
Ste 100
Huntsville, AL 35801
Phone (256) 319-5400

Organizations & group practices 4

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": "1330473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769558400000",
    "number": "1841564481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18428",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358048428",
            "telephone_number": "256-705-4224",
            "fax_number": "256-705-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR SW STE 100",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013495",
            "telephone_number": "256-319-5400",
            "fax_number": "256-327-5977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 Cci Dr NW Ste 10",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358052609",
            "country_code": "US",
            "telephone_number": "256-319-5400",
            "fax_number": "256-327-5977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 Sivley Rd SW Ste 10",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358015138",
            "country_code": "US",
            "telephone_number": "256-319-5400",
            "fax_number": "256-327-5977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KIMBERLY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-29",
        "last_updated": "2026-01-28",
        "certification_date": "2026-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-092883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.