Individual provider Active NPI

Ellen Mildred Convery, CRNA

  • Certified Registered Nurse Anesthetist
  • Marlton, NJ
National Provider Identifier
1922230069
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
26NJ00277600 Issued in NJ
Practice address
102 Centre Blvd Ste E
Marlton, NJ 08053-4129
Phone
(956) 988-6260
Fax
(856) 988-6270
NPI assigned
Aug 21, 2009
Last updated
Feb 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 26NJ00277600 NJ Primary
Certified Registered Nurse Anesthetist 367500000X C-APN.0105684-C-CRNA CO

Addresses

Primary practice location

102 Centre Blvd Ste E
Marlton, NJ 08053-4129

Mailing address

102 Centre Blvd Ste E
Marlton, NJ 08053-4129
Phone (956) 988-6260

Other practice location 1

400 W 16th St
Pueblo, CO 81003-2745
Phone (719) 584-4045

Other practice location 2

200 S Orange Ave
Livingston, NJ 07039-5817
Phone (973) 577-4056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, OH, TX, SC, NC, CO6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20100322000422 NJ Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698800282 Reassigns benefits to 1 organization
I20201118003287 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698800282 Reassigns benefits to 1 organization
I20220201001339 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698800282 Reassigns benefits to 1 organization
I20240202002444 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698800282 Reassigns benefits to 2 organizations
I20250609001129 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698800282 Reassigns benefits to 1 organization
I20260302001011 CO Practitioner - Certified Registered Nurse Anesthetist (Crna) 5698800282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Atlantic Coast Anesthesia Services PCGroup PAC ID 3971887167, 71 clinicians
Trident Anesthesia Group LLCGroup PAC ID 5294631545, 121 clinicians

Practice addresses (Care Compare)

400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

9330 Medical Plaza Dr
Charleston, SC 29406-9104
Phone (843) 797-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
43.93 of 100Reported as group
Quality
34.03
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
7372NCMDGeneral Practice Dentistry
C-APN.0105684-C-CRNACOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Mar 2, 2026 Accepting new patients
CHS Anesthesia Services Group Inc CurrentSince Jun 2, 2025 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Mar 2, 2026 Accepting new patients
Trident Anesthesia Group, LLC CurrentSince Apr 4, 2025 Accepting new patients
North American Partners in Anesthesia of New Jersey LLC CurrentSince Apr 1, 2023 Accepting new patients
West Jersey Anesthesia Associate PA CurrentSince Jan 13, 2010 Accepting new patients
Dayton Anesthesia & Pain Services, LLC Nurse Anesthetist, Certified Registered CurrentSince Nov 10, 2020 Accepting new patients
Hendrick Anesthesia Network CurrentSince Jan 1, 2022 Accepting new patients
Atlantic Coast Anesthesia Services P.C. Nurse Anesthetist, Certified Registered CurrentSince Jan 29, 2024 Accepting new patients
Capstone Behavioral Health L.L.C. PastSince Aug 25, 2019 Accepting new patients

Locations

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

200 S Orange Ave
Livingston, NJ 07039
Phone (973) 322-7007

300 2nd Ave
Long Branch, NJ 07740
Phone (732) 222-5200

102 Centre Blvd
Ste E
Marlton, NJ 08053
Phone (856) 462-6400

703 Main St
Paterson, NJ 07503
Phone (973) 754-2240

1000 White Horse Rd
Ste 204
Voorhees, NJ 08043
Phone (856) 309-5808

200 Bowman Dr
Ste D160
Voorhees, NJ 08043
Phone (856) 247-3000

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

405 W Grand Ave
Dayton, OH 45405
Phone (937) 226-3200

423 Barony St
Moncks Corner, SC 29461

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

9313 Medical Plaza Dr
Ste 102
North Charleston, SC 29406
Phone (843) 572-1228

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

295 Midland Pkwy
Summerville, SC 29485
Phone (843) 554-6366

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 985-7114

265 Brookview Centre Way
Ste 400
Knoxville, TN 37919
Phone (865) 293-5549

1900 Pine St
Abilene, TX 79601
Phone (325) 670-4220

751 N 18th St
Abilene, TX 79601
Phone (915) 676-0557

Organizations & group practices 10

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1250812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1922230069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CENTRE BLVD STE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534129",
            "telephone_number": "956-988-6260",
            "fax_number": "856-988-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CENTRE BLVD STE E",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534129",
            "telephone_number": "956-988-6260",
            "fax_number": "856-988-6270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W 16th St",
            "address_purpose": "LOCATION",
            "city": "Pueblo",
            "state": "CO",
            "postal_code": "810032745",
            "country_code": "US",
            "telephone_number": "719-584-4045",
            "fax_number": "719-542-0809",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 S Orange Ave",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070395817",
            "country_code": "US",
            "telephone_number": "973-577-4056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONVERY",
        "first_name": "ELLEN",
        "middle_name": "MILDRED",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-21",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NJ",
            "license": "26NJ00277600",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CO",
            "license": "C-APN.0105684-C-CRNA",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.