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DR. CAROLYN ANN ELLSWORTH M.D.
NPI 1679570618
Pediatrics - Adolescent Medicine in West Plains, MO

Active since July 06, 2005PECOS Enrolled
312 N KENTUCKY ST, WEST PLAINS, MO 65775(417) 257-7076(417) 257-1417 Get Directions Write a Review

NPPES record last updated: November 1, 2011. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Dr. Carolyn Ann Ellsworth M.d. NPPES

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

DR. CAROLYN ANN ELLSWORTH M.D. (NPI 1679570618) is an individual adolescent medicine provider in West Plains, Missouri, licensed in Missouri (102421) and active in the NPI registry since July 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679570618
Entity TypeIndividualFemale
Primary Taxonomy2080A0000X
Provider Legal NameDR. CAROLYN ANN ELLSWORTHCredential: M.D.
Location Address312 N KENTUCKY STWest Plains, MO 65775-2073
Mailing Address312 N Kentucky StWest Plains, MO 65775-2073 · (417) 257-7076 · Fax (417) 257-1417
Phone(417) 257-7076
Fax(417) 257-1417
Sole ProprietorNo
Enumeration DateJuly 6, 2005
Last NPPES UpdateNovember 1, 2011
✔ NPI 1679570618 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in MO · 102421
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
312 N KENTUCKY ST, West Plains, MO 65775
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Other Identifiers 2

Medicaid203592001MO
Medicaid123942001AK

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Carolyn Ann Ellsworth M.d. 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.

Medicare Billing Reassignment

Medicare enrollment records show Carolyn Ellsworth reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ozarks Medical Center
0.1 mi
Rural Health
312 N KENTUCKY AVE
West Plains, MO 65775
  • Reassigned Medicare billing, Missouri enrollment
  • 338 clinicians in this Medicare group
NPI 1154838209 (417) 257-7076

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

Other Providers at the Same Location NPPES 2

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

BILL STAFFORD, M.D.
Clinic/Center (Rural Health)
312 N KENTUCKY ST
WEST PLAINS, MO 65775
Howell County (417) 257-7076
MS. ELLEN BIVENS
Physician Assistant (Medical)
312 N KENTUCKY ST
WEST PLAINS, MO 65775
Howell County (417) 257-7076

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 Carolyn Ellsworth's NPI number?

The NPI number for Carolyn Ellsworth is 1679570618. It was assigned to this individual provider in the NPPES registry on July 6, 2005.

Where is Carolyn Ellsworth located?

Carolyn Ellsworth practices at 312 N Kentucky St, West Plains, MO 65775. The listed phone number is (417) 257-7076.

What is Carolyn Ellsworth's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Carolyn Ellsworth enrolled in Medicare?

Yes. Carolyn Ellsworth is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Carolyn Ellsworth's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carolyn Ellsworth reassigns Medicare benefits to Ozarks Medical Center (West Plains, MO). The 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 Carolyn Ellsworth's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carolyn Ellsworth accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 5 other insurers list Carolyn Ellsworth as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Carolyn Ellsworth was last updated on November 1, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.