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CARLY ELLISON APN NPI 1508245028


NPI Information

NPI: 1508245028
Provider Name: CARLY ELLISON, APN
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
2901 OLD JACKSONVILLE RD
SPRINGFIELD, IL
ZIP 62704
Phone: (217) 698-9722
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Carly Ellison, APN is a primary care nurse practitioner in Springfield, IL with 3 years of experience. Carly Ellison, APN NPI is 1508245028. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2901 OLD JACKSONVILLE RD
SPRINGFIELD, IL
ZIP 62704-437
Phone: (217) 698-9722
Fax: (217) 391-0392

The NPI 1508245028 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Complete blood cell count (red cells, white blood cell, platelets), automated test (HCPCS:85025)
  • Blood test, comprehensive group of blood chemicals (HCPCS:80053)
  • Hemoglobin a1c level (HCPCS:83036)

The enumeration date for this NPI number is 5/29/2015 and was last updated on 4/18/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LF0000XNurse PractitionerFamily209012884ILLINOISNo
2363LP2300XNurse PractitionerPrimary Care209012884ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.