MRS. ELLY JO FENNELL (RN, CNP) – Clinical Nurse Specialist, NPI 1114245958
Clinical Nurse Specialist
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
8,191 NURSE PRACTITIONER in IN
Provider Addresses for MRS. ELLY JO FENNELL (RN, CNP)
PO BOX 637764
CINCINNATI, OH 452637764
Phone: (317) 880-3939
Type: Mailing
720 ESKENAZI AVE
INDIANAPOLIS, IN 462025187
Phone: (317) 880-7666
Type: Location
3900 ST FRANCIS WAY STE 205
LAFAYETTE, IN 479054939
Phone: (765) 428-2500
Fax: (765) 428-2505
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $43.
Total Amount is formed as General ($43) + Research ($0) + Ownership ($0) = $43.
Last reported payment date: 2023-10-06 • Largest payer in this snapshot: PFIZER INC. ($43).
Total Amount
$43
General + Research + Ownership
Payments
1
Total payment records
General Amount
$43
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PFIZER INC. | $43 |
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: 2019-11-13
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 |
|---|---|---|---|---|
| I20191113002644 | I | Nurse Practitioner | IN | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 20 | 15 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 15 | 14 | $0 |
Insurance plans in this area (ZIP 45263)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IN | |
| H O S P I T A L I S T | OH | |
| - | IN | |
| Nurse Practitioner | IN | |
| Internal Medicine, Hospitalist | NM | |
| Internal Medicine | IN | |
| - | IN | |
| Internal Medicine | IN | |
| Hospitalist, Pediatric Medicine | IN | |
| Nurse Practitioner | IN |
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