MS. BEVERLY DAWN ELLIS (APRN) – Family Nurse Practitioner, NPI 1124488903
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MS. BEVERLY DAWN ELLIS (APRN)
1219 W Main St
West Liberty, KY 414722161
Phone: (606) 743-4808
Fax: (606) 743-4716
Type: Location
202 Plummer St
Campton, KY 413019381
Phone: (606) 668-7385
Fax: (606) 668-7009
Type: Location
308 N KY 7
Sandy Hook, KY 411717134
Phone: (606) 738-9785
Fax: (859) 317-2148
Type: Location
PO BOX 690
BEATTYVILLE, KY 413110690
Phone: (606) 464-0151
Fax: (606) 464-0152
Type: Mailing
Lakeside Drive, Kansas City, Jackson County, Missouri, 64132, United States
JACKSON, KY 413396555
Phone: (606) 666-9950
Fax: (606) 666-9136
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $76.
Total Amount is formed as General ($76) + Research ($0) + Ownership ($0) = $76.
Last reported payment date: 2023-12-12 • Largest payer in this snapshot: ABBVIE INC. ($42).
Total Amount
$76
General + Research + Ownership
Payments
4
Total payment records
General Amount
$76
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-12-12
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $42 |
| Medtronic, Inc. | $18 |
| Ultragenyx Pharmaceutical Inc. | $16 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2016-04-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160427001694 | I | Nurse Practitioner | KY | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 41472)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | KY | |
| Family Practice | KY | |
| Clinical Social Worker | KY | |
| Physician Assistant | KY | |
| Nurse Practitioner | KY | |
| Nurse Practitioner | KY | |
| Internal Medicine | KY | |
| Clinical Social Worker | KY | |
| Nurse Practitioner | KY | |
| Family Practice | KY |
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