Rebecca Ellen, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R222482 Issued in MD

Practice address

6999 Reisterstown Rd Ste 4
Attention Rebecca Ellen
Baltimore, MD 21215-1492

Phone

(305) 720-4743

NPI assigned

Jan 17, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Luminis Health Medical Group, LLC

  • Maternal & Fetal Medicine Physician
  • Annapolis, MD
  • NPI 1073580205
  Medicare reassignment Care Compare group NPD
• Luminis Health Medical Group, LLC

  • Internal Medicine Physician
  • Bowie, MD
  • NPI 1720835010
  NPD
• Luminis Health Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Annapolis, MD
  • NPI 1790277614
  NPD
• Kraus Behavioral Health LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Windsor Mill, MD
  • NPI 1215472923
  NPD (past)

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1962740407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6999 REISTERSTOWN RD STE 4",
            "address_2": "ATTENTION REBECCA ELLEN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212151492",
            "telephone_number": "305-720-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6999 REISTERSTOWN RD STE 4",
            "address_2": "ATTENTION REBECCA ELLEN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212151492",
            "telephone_number": "305-720-4743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEN",
        "first_name": "REBECCA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-17",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R222482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Holmes
• Elka Health Services LLC
• Evan Michael Elkin, LGPC
• Ella'S in Home Care Inc
• Ella'S Sunshine Assisted Living LLC
• Danielle Gisel Ellenberg
• Shannon Yi Eller, PHARMD
• Sheila Eller
• Nicole Ellerbe
• Tatiana Ellerbe

• Psychiatric/Mental Health Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.