Individual provider Active NPI

Stephanie Lynn Ellis, DNP, FNP-BC

  • Nurse Practitioner
  • Washington, NC
National Provider Identifier
1922617224
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5013473 Issued in NC
Practice address
1380 Cowell Farm Rd
Washington, NC 27889-3431
Phone
(252) 946-2101
NPI assigned
Jul 23, 2020
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5013473 NC Primary

Addresses

Primary practice location

1380 Cowell Farm Rd
Washington, NC 27889-3431

Mailing address

1380 Cowell Farm Rd
Washington, NC 27889-3431
Phone (252) 946-2101

Other names 1

  • Stephanie Lynn Lewis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20200916001962 NC Practitioner - Nurse Practitioner 1052739406 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians
East Carolina Anesthesia Associates PLLCGroup PAC ID 5092720813, 691 clinicians

Practice addresses (Care Compare)

1380 Cowell Farm Rd
Washington, NC 27889-3431
Phone (252) 946-2101

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5013473NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Down East Inc CurrentSince Sep 9, 2023 Accepting new patients
East Carolina Anesthesia Associates, PLLC CurrentSince Jan 17, 2024 Accepting new patients
Vidant Medical Group LLC CurrentSince Aug 13, 2025 Accepting new patients
Williamston Clinic Corp Nurse Practitioner CurrentSince Nov 1, 2020 Accepting new patients
Williamston Hospital Corporation PastSince Mar 9, 2020 Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

1380 Cowell Farm Rd
Washington, NC 27889
Phone (252) 946-0900

853 Washington Square Mall
Washington, NC 27889
Phone (252) 623-2000

104 Medical Dr
Williamston, NC 27892
Phone (252) 809-6300

232 Green St
Williamston, NC 27892
Phone (252) 792-6611

Organizations & group practices 5

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 2

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": "1595462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1922617224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 COWELL FARM RD",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893431",
            "telephone_number": "252-946-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 COWELL FARM RD",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278893431",
            "telephone_number": "252-946-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-23",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5013473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "LEWIS",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Washington, NC

Sources for this page

Verify at the official NPI Registry.