Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Lisa Annette Ellingwood, APRN, PMHNP-BC

Individual provider Registered Nurse · NPI 1083255343

MS. Lisa Annette Ellingwood, APRN, PMHNP-BC is a Nurse Practitioner in Champaign, Illinois. Qualified in 2019, 7 years ago. Practices with Carle Health Care Incorporated, a 1,543-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
7
Licensed in
IL
In the registry since
2019
Specialties on file
2
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

1802 S Mattis Ave
Champaign, IL 61821-5923
Phone: (217) 365-2855
Fax: (217) 365-2856
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 209.020407 (IL)
Registered Nurse Taxonomy 163W00000X · Licence 041.385774 (IL)

Record details

NPI number1083255343
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN , PMHNP-BC
Sole proprietorYes
NPI enumeratedOctober 7, 2019
Last updated in NPPESApril 22, 2024
Certification dateJune 2, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Carle Health Care Incorporated — 1543 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Champaign