KIMBERLY CAROL ELLISON NP
NPI 1205094174
Nurse Practitioner - Family in Wytheville, VA

Active since May 28, 2008PECOS EnrolledAccepts Medicare Assignment
770 W RIDGE RD STE 220, WYTHEVILLE, VA 24382(276) 223-3202 Get Directions Write a Review

NPPES record last updated: October 26, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 15, 2020, Sep 21, 2018, Feb 1, 2017 (3 updates tracked since 2017).

About Kimberly Carol Ellison Np NPPES

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

KIMBERLY CAROL ELLISON NP (NPI 1205094174) is an individual family provider in Wytheville, Virginia, licensed in Virginia (0024167810) and active in the NPI registry since May 2008. She is enrolled in Medicare PECOS, is affiliated with Wythe County Community Hospital, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1205094174
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKIMBERLY CAROL ELLISONCredential: NP
Location Address770 W RIDGE RD STE 220Wytheville, VA 24382-1187
Mailing Address770 W Ridge RdWytheville, VA 24382-1187 · (276) 223-3200 · Fax (276) 223-0617
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateMay 28, 2008
Last NPPES UpdateOctober 26, 20213 updates tracked since enumeration
NPPES CertifiedOctober 26, 2021
NPI 1205094174 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 VA · 0024167810
770 W RIDGE RD STE 220, Wytheville, VA 24382

Other Identifiers 2

Medicaid1205094174VA
MedicaidQ008296TN

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kimberly Carol Ellison Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062659600
PECOS Enrollment IDI20140602001416
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Wythe County Community Hospital

Acute Care Hospitals · Wytheville, VA
3/5 CMS rating
OwnershipProprietary
CMS Certification Number490111
Location600 West Ridge RoadWytheville, VA 24382 · Wythe County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 24382 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers13 claims13 services$82.36 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Social Worker (Clinical)
770 W RIDGE RD STE 220
WYTHEVILLE, VA 24382
Social Worker (Clinical)
770 W RIDGE RD STE 220
WYTHEVILLE, VA 24382
Counselor (Professional)
770 W RIDGE RD STE 220
WYTHEVILLE, VA 24382
Counselor (Professional)
770 W RIDGE RD STE 220
WYTHEVILLE, VA 24382
Counselor (Professional)
770 W RIDGE RD STE 220
WYTHEVILLE, VA 24382
Counselor (Professional)
770 W RIDGE RD STE 220
WYTHEVILLE, VA 24382
Counselor (Professional)
770 W RIDGE RD STE 220
WYTHEVILLE, VA 24382
Counselor (Professional)
770 W RIDGE RD STE 220
WYTHEVILLE, VA 24382

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 Kimberly Ellison's NPI number?

The NPI number for Kimberly Ellison is 1205094174. It was assigned to this individual provider in the NPPES registry on May 28, 2008.

Where is Kimberly Ellison located?

Kimberly Ellison practices at 770 W Ridge Rd Ste 220, Wytheville, VA 24382. The listed phone number is (276) 223-3202.

What is Kimberly Ellison's specialty?

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

Is Kimberly Ellison enrolled in Medicare?

Yes. Kimberly Ellison is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Kimberly Ellison affiliated with any hospitals?

According to CMS data, Kimberly Ellison is affiliated with Wythe County Community Hospital.

When was this NPI record last updated?

The NPPES record for Kimberly Ellison was last updated on October 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.