1. Home
  2. Directory
  3. Florida
  4. Tavares
  5. Family Medicine
  6. NPI Profile

ELLIS INTEGRATIVE FAMILY PRACTICE INC
NPI 1174101562
Family Medicine in Tavares, FL

Active since March 29, 2021
1865 NIGHTINGALE LN STE B, TAVARES, FL 32778(352) 457-1936 Get Directions Write a Review

NPPES record last updated: April 19, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 19, 2021, Apr 2, 2021 (2 updates tracked since 2021).

About Ellis Integrative Family Practice Inc NPPES

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

ELLIS INTEGRATIVE FAMILY PRACTICE INC (NPI 1174101562) is a healthcare organization registered as a family medicine in Tavares, Florida and active in the NPI registry since March 2021. The organization lists Gretta Ellis, President, as its authorized official.

NPPES Registry Identity

NPI1174101562
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameELLIS INTEGRATIVE FAMILY PRACTICE INC
Location Address1865 NIGHTINGALE LN STE BTavares, FL 32778-4360
Mailing Address1865 Nightingale LnTavares, FL 32778-4360 · (352) 457-1936
Phone(352) 457-1936
Organization SubpartNo
Authorized OfficialGretta EllisPresident · (352) 457-1936
Enumeration DateMarch 29, 2021
Last NPPES UpdateApril 19, 20212 updates tracked since enumeration
NPPES CertifiedApril 19, 2021
✔ NPI 1174101562 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1865 NIGHTINGALE LN STE B, Tavares, FL 32778
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ellis Integrative Family Practice Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateFloridaEnrollment IDO20210604000448Non-DME Part B · Clinic/Group PracticeDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Ellis Integrative Family Practice Inc, which bills Medicare for the services this clinician delivers.

Clinician (1)

Gretta Ellis
Nurse Practitioner
NPI 1457826281
1865 NIGHTINGALE LN STE B
Tavares, FL 32778
(352) 508-5419
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ellis Integrative Family Practice Inc's NPI number?

The NPI number for Ellis Integrative Family Practice Inc is 1174101562. It was assigned to this organization in the NPPES registry on March 29, 2021.

Where is Ellis Integrative Family Practice Inc located?

Ellis Integrative Family Practice Inc is located at 1865 Nightingale Ln Ste B, Tavares, FL 32778. The listed phone number is (352) 457-1936.

What is Ellis Integrative Family Practice Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ellis Integrative Family Practice Inc enrolled in Medicare?

Yes. Ellis Integrative Family Practice Inc is registered in the Medicare PECOS enrollment system.

When is Ellis Integrative Family Practice Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Florida, Clinic/Group Practice) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Ellis Integrative Family Practice Inc?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Ellis Integrative Family Practice Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Ellis Integrative Family Practice Inc was last updated on April 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.