ELIZABETH A. ELLIS DNP, FNP-C
NPI 1104518596
Nurse Practitioner - Family in Dothan, AL

Q: What is Elizabeth Ellis's NPI number?

The NPI number for Elizabeth Ellis is 1104518596. It was assigned to this individual provider in the NPPES registry on May 23, 2023.

Q: What is Elizabeth Ellis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Elizabeth Ellis was last updated on March 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 23, 2023PECOS Enrolled

2812 HARTFORD HWY STE 1, DOTHAN, AL 36305(334) 712-1170(334) 460-8391 Get Directions Write a Review

NPPES record last updated: March 20, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 29, 2023, May 23, 2023 (2 updates tracked since 2023).

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About Elizabeth A. Ellis Dnp, Fnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZABETH A. ELLIS DNP, FNP-C (NPI 1104518596) is an individual family provider in Dothan, Alabama, licensed in Alabama (1-106812) and active in the NPI registry since May 2023. She is enrolled in Medicare PECOS and maintains a secondary practice location in Ozark.

NPPES Registry Identity

NPI1104518596

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameELIZABETH A. ELLISCredential: DNP, FNP-C

Location Address2812 HARTFORD HWY STE 1Dothan, AL 36305-4927

Mailing Address1703 N County Road 67Skipperville, AL 36374-5834 · (334) 701-0224

Phone(334) 712-1170

Fax(334) 460-8391

Sole ProprietorYes

Enumeration DateMay 23, 2023

Last NPPES UpdateMarch 20, 20242 updates tracked since enumeration

NPPES CertifiedMarch 20, 2024

✔ NPI 1104518596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in AL · 1-106812

2812 HARTFORD HWY STE 1, Dothan, AL 36305

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Secondary Practice Location 1

Location 11970 Andrews AveOzark, AL 36360-3726 · Phone (334) 774-1555 · Fax (334) 443-0213

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elizabeth A. Ellis Dnp, Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 36305 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.90 typical visit price

range $52.65 – $161.63

Typical copayment $20.47 (range $13.16 – $40.40)

Most-billed visit code 99203

Established Patient

$93.72 typical visit price

range $16.56 – $131.65

Typical copayment $23.43 (range $4.14 – $32.91)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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