Kelly Elizabeth Ellis, APN, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

209008508 Issued in IL

Practice address

5000 E Main St
Columbus, OH 43213-2440

Phone

(614) 235-5555

Fax

(614) 536-1994

NPI assigned

Dec 9, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

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.

• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Oak Park, IL
  • NPI 1871516799
  Medicare reassignment NPD
• Heart of Ohio Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
  • NPI 1275714289
  Medicare reassignment
• Heart of Ohio Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Westerville, OH
  • NPI 1255041190
  NPD
• Heart of Ohio Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Whitehall, OH
  • NPI 1306083340
  NPD
• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1134954506
  NPD

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1962705103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432132440",
            "telephone_number": "614-235-5555",
            "fax_number": "614-536-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 E MAIN ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432132440",
            "telephone_number": "614-235-5555",
            "fax_number": "614-536-1994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "124 S Main St Unit A",
            "address_purpose": "LOCATION",
            "city": "Granville",
            "state": "OH",
            "postal_code": "430231409",
            "country_code": "US",
            "telephone_number": "740-279-3990",
            "fax_number": "740-212-8368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KELLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "APN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-09",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209008508",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Ellis
• Heather Ellis
• Jameela Ellis
• Jennifer Watters Ellis, MD
• Joyce Irene Ellis
• Leanna Grace Ellis, PA-C
• Marcy Ellis
• Mary Ellis
• Megan Ann Ellis, LISW-S
• Mitchel Ellis, CRNA

• Advanced Practice Midwife in Columbus, OH
• Providers in Columbus, OH by specialty
• Advanced Practice Midwife in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.
• 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.