TINA MARLENE ELLIS (NPI# 1053648436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053648436 |
| Entity Type | Individual |
| Full Name | TINA MARLENE ELLIS |
| Credential | PA |
| Practice Address |
4969 Centre Pointe Dr Ste 100 North Charleston SC 29418-6975 |
| Practice Telephone | 8438530250 |
| Practice Fax Number | 8436068103 |
| Mailing Telephone | 8438530250 |
| Mailing Fax Number | 8436068103 |
| Enumeration Date | 2009-11-05 |
| Last Update Date | 2019-10-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2889 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
2889 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 4750017 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124392592 | Tina Ellis | Counselor | 229 A St, Magnolia, AR 71753-3653 | 2012-03-02 |
| 1497072631 | Tina Marie Ellis | Anesthesiology | 593 Eddy St, Davol 129, Providence, RI 02903-4923 | 2010-04-28 |
| Street Address |
4969 CENTRE POINTE DR STE 100 |
| City | NORTH CHARLESTON |
| State | SC |
| Zip Code | 29418-6975 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861485088 | Donald E Saunders IIi | Internal Medicine | 4969 Centre Pointe Dr, Suite 100, North Charleston, SC 29418-6952 | 2005-08-23 |
| 1114328408 | Christopher Andrew Davis | Physician Assistant | 4969 Centre Pointe Dr, Suite 100, North Charleston, SC 29418-6952 | 2014-09-06 |
| 1306043823 | Monique Kaur Sandhu | Internal Medicine | 4969 Centre Pointe Dr, Suite 100, North Charleston, SC 29418-6952 | 2007-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710529235 | Safe Keeping Healthcare LLC | Home Health | 2850 Ashley Phoshate Rd Suite J, Charleston, SC 29418 | 2019-10-16 |
| 1487136180 | Aston J Rosenberg | Speech-Language Pathologist | 4362 Leslie St, North Charleston, SC 29418 | 2018-08-30 |
| 1285178996 | Aaron Brown | Counselor | 5060 Dorchester Road, Suite 200, North Charleston, SC 29418 | 2016-12-14 |
| 1003265828 | Health Edge Laser LLC | Chiropractor | 4965 Centre Pointe Dr. Suite 100, North Charleston, SC 29418 | 2016-06-13 |
| 1568866481 | Rickey Ciapha Dennis Sr. | Social Worker | 108 Knightsbridge Drive, North Charleston, SC 29418 | 2014-10-21 |
| 1780086330 | Stephanie Washington | Specialist | 5060 Drochester Rd, North Charleston, SC 29418 | 2014-09-25 |
| 1043631369 | Julian H. Campbell, Dmd PC | Dentist | 3188 W. Montague Ave, North Charleston, SC 29418 | 2014-01-05 |
| 1750660676 | Marie's Home Care | Home Health | 7610 Mcknight St., Apt.a, North Charleston, SC 29418 | 2011-08-09 |
| 1437437548 | Trident General Dentistry, Douglas S Rawls, Dm | Dentist | 6335 Dorchester Road, North Carleston, SC 29418 | 2011-07-25 |
| 1508165291 | Patrick Michael Looser | Internal Medicine | 4969 Centre Pointe Dr Ste 100, North Charleston, SC 29418 | 2011-03-21 |
| Find all providers in zip 29418 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790383719 | Kaytlin Blake Hollingsworth | Physician Assistant | 2774 Shadow Ln, North Charleston, SC 29406-9065 | 2020-10-12 |
| 1649813106 | Sandy Pang | Physician Assistant | 2448 Melville Rd, North Charleston, SC 29406-8905 | 2019-10-28 |
| 1568933877 | April Marie Ridenhour | Physician Assistant | 7713 Brookdale Blvd, North Charleston, SC 29418-2139 | 2018-12-13 |
| 1659822823 | Lauren Olson | Physician Assistant | 2998 W Montague Ave Ste 117, North Charleston, SC 29418-5931 | 2016-10-21 |
| 1730581257 | Vanessa A Hajzus | Physician Assistant | 8950 University Blvd Ste 150, North Charleston, SC 29406-9115 | 2014-09-16 |
| 1205168960 | Robert Michael Drew | Physician Assistant | 2233 Northwoods Blvd., Roper Northwoods Emergency Department, North Charleston, SC 29406 | 2010-02-05 |
| 1558512525 | Amanda Rene Thomasson | Physician Assistant | 8091 Rivers Avenue, North Charleston, SC 29406 | 2008-10-08 |
| 1750578688 | Christopher Chillura | Physician Assistant | 7750 Northwoods Blvd, North Charleston, SC 29406-4034 | 2007-09-25 |
| 1477508901 | Steven Scott Garver | Physician Assistant | 8992 University Blvd, Ste 300, North Charleston, SC 29406-8104 | 2006-05-23 |
| 1336113232 | Rebecca Hamilton Miller | Physician Assistant | 9213a University Blvd, Trident Executive Village, North Charleston, SC 29406 | 2006-02-15 |
| Find all providers in NORTH CHARLESTON | ||||
| City | NORTH CHARLESTON |
| Zip Code | 29418 |
Please comment or provide details below to improve the information on TINA MARLENE ELLIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.