KELLY ANNE ELLISON (NPI# 1265823843) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265823843 |
| Entity Type | Individual |
| Full Name | KELLY ANNE ELLISON |
| Practice Address |
1905 Doctors Hospital Dr Bridgeport TX 76426-2260 |
| Mailing Address |
2000 S Fm 51 Decatur TX 76234-3702 |
| Practice Telephone | 9406830300 |
| Practice Fax Number | 9406830491 |
| Mailing Telephone | 9406830300 |
| Mailing Fax Number | 9406830491 |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2015-02-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
AP127337 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | PENDING | 01 |
| TX | PENDING | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104115617 | Kelly Ellison | Counselor | 800 Cummings Ctr, Beverly, MA 01915-6175 | 2011-04-05 |
| Street Address |
1905 DOCTORS HOSPITAL DR |
| City | BRIDGEPORT |
| State | TX |
| Zip Code | 76426-2260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154364198 | Elva Alejandro Camero | Family Medicine | 1905 Doctors Hospital Dr, Suite33, Bridgeport, TX 76426-2260 | 2006-06-14 |
| 1326387481 | Bridgeport Emergency Medicine Associates Pa | Physician Assistant | 1905 Doctors Hospital Dr, Bridgeport, TX 76426-2260 | 2013-02-11 |
| 1225347396 | Blaylock Anesthesia Group | Contractor | 1905 Doctors Hospital Dr, Bridgeport, TX 76426-2260 | 2010-10-06 |
| 1609015072 | Steve Longacre M.d. Pa | Emergency Medicine | 1905 Doctors Hospital Dr, Bridgeport, TX 76426-2260 | 2009-02-09 |
| 1316119571 | Mihir Umesh Talati | Family Medicine | 1905 Doctors Hospital Dr, Bridgeport, TX 76426-2260 | 2008-03-27 |
| 1609053974 | West 380 Family Care Facility | General Acute Care Hospital | 1905 Doctors Hospital Dr, Bridgeport, TX 76426-2260 | 2008-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790169613 | Victor Esmeraldo | Dentist | 1808 Chico Hwy, Bridgeport, TX 76426 | 2015-07-10 |
| 1376941013 | K&h Dental Pa | Clinic/Center | 1808 Chico Highway, Bridgeport, TX 76426 | 2014-12-11 |
| 1710252572 | Jonathon Stanley Scarborough | Nurse Anesthetist, Certified Registered | 1509 Dr. Hospital Drive, Bridgeport, TX 76426 | 2012-03-13 |
| 1124153010 | Christopher Aaron Hicks | Physical Therapist | 707 Woodrow Wilson Ray Cir, Bridgeport, TX 76426 | 2007-02-22 |
| 1578636411 | 34hha, Inc | Home Health | 401 Center Ct., Bridgeport, TX 76426 | 2006-11-16 |
| 1295777902 | West 380 Nursing Center | Assisted Living Facility | 2108 15th St, Bridgeport, TX 76426 | 2006-06-10 |
| 1780810234 | Scc Partners Inc | Skilled Nursing Facility | 2108 15th St, Bridgeport, TX 76426 | 2009-06-10 |
| 1477175628 | Noemi Araceli Meza | Non-emergency Medical Transport (VAN) | 1006 Newby Ave, Bridgeport, TX 76426-2030 | 2020-05-11 |
| 1992013692 | Bridgeport Isd | Local Education Agency (LEA) | 2107 15th St, Bridgeport, TX 76426-2052 | 2010-09-16 |
| 1952853194 | City of Ennis | Skilled Nursing Facility | 2108 15th St, Bridgeport, TX 76426-2055 | 2016-11-03 |
| Find all providers in zip 76426 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952823072 | Judith Elizabeth Wiehl | Nurse Practitioner | 267 Grant St, Bridgeport, CT 06610-2805 | 2017-07-11 |
| 1518331347 | Rebecca Ann Chanda | Nurse Practitioner | 2800 Main St, Bridgeport, CT 06606-4201 | 2015-11-17 |
| 1366828907 | Christine M Needham | Nurse Practitioner | 267 Grant St, Bridgeport, CT 06610-2805 | 2015-08-05 |
| 1518186808 | Lisa Maria Kegel | Nurse Practitioner | 439 Mill Hill Ave, Bridgeport, CT 06610 | 2007-04-25 |
| 1821177122 | Lorrie Dilucente | Nurse Practitioner | 527 Medical Park Dr Ste 402, Bridgeport, WV 26330-9010 | 2006-11-06 |
| 1962423392 | Karen Marie Petrok | Nurse Practitioner | 226 Mill Hill Ave, 3rd Floor, Bridgeport, CT 06610-2826 | 2006-07-21 |
| 1083652176 | Gregory Howard Emmens II | Nurse Practitioner | 267 Grant St, Bridgeport, CT 06610-2805 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215800 | Kellie Lynn Myers | Nurse Practitioner | 26015 Penguin St, Magnolia, TX 77355-6249 | 2020-11-06 |
| 1356942148 | Nina Nicole Totanes | Nurse Practitioner | 12709 Toepperwein Rd Ste 203, Live Oak, TX 78233-3259 | 2020-11-06 |
| 1841890415 | Glenda Kelley | Nurse Practitioner | 8902 W State Highway 56, Savoy, TX 75479-3460 | 2020-10-31 |
| 1184223786 | Vincy Saji Mathew | Nurse Practitioner | 8804 Viridian Ln, Fort Worth, TX 76123-4030 | 2020-10-23 |
| 1265030787 | Lissa Flory | Nurse Practitioner | 4679 Dreibrodt Rd, San Marcos, TX 78666-3388 | 2020-10-16 |
| 1235737941 | Barton Skinner | Nurse Practitioner | 17806 W I-10, Suite 300, San Antonio, TX 78257 | 2020-10-14 |
| 1972101897 | Biny Sam George | Nurse Practitioner | 7207 Baitland Dr, Missouri City, TX 77459-2035 | 2020-10-13 |
| 1285231282 | Nkechi I Carter | Nurse Practitioner | 1550 Katy Gap Rd Apt 1406, Katy, TX 77494-5878 | 2020-10-03 |
| 1770190753 | Julius Osabor Obianke | Nurse Practitioner | 1000 Fallon Dr, Mckinney, TX 75071-1210 | 2020-09-24 |
| 1740896315 | Mackenzie Brooks Jackson | Nurse Practitioner | 46 N Creekside Ct, Houston, TX 77055-7540 | 2020-09-19 |
| Find all providers with the same taxonomy | ||||
| City | BRIDGEPORT |
| Zip Code | 76426 |
Please comment or provide details below to improve the information on KELLY ANNE ELLISON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.