DAVID J ELLINGSON (NPI# 1144228685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144228685 |
| Entity Type | Individual |
| Full Name | DAVID J ELLINGSON |
| Credential | P.A. |
| Practice Address |
3120 Waterman Way Tavares FL 32778-5252 |
| Practice Telephone | 3523431216 |
| Practice Fax Number | 3523431582 |
| Mailing Telephone | 3523431216 |
| Mailing Fax Number | 3523431582 |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2014-04-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9102690 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 291796300 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689856148 | David John Ellingson | Dentist | 3549 E Brown Rd, Ste 104, Mesa, AZ 85213-5508 | 2007-11-27 |
| 1649463191 | David S Ellingson | Counselor | 730 Sunrise Avenue, Building 200, Ste-201, Roseville, CA 95661 | 2007-08-18 |
| Street Address |
3120 WATERMAN WAY |
| City | TAVARES |
| State | FL |
| Zip Code | 32778-5252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154327872 | Gary S. Allen | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3120 Waterman Way, Tavares, FL 32778-5252 | 2005-06-27 |
| 1598244030 | Stephanie Alison Wert | Surgery | 3120 Waterman Way, Tavares, FL 32778-5252 | 2018-08-07 |
| 1720211451 | Theresa A D'avila | Physician Assistant | 3120 Waterman Way, Tavares, FL 32778-5252 | 2009-08-28 |
| 1811995889 | Dennis Harkness | Physician Assistant | 3120 Waterman Way, Tavares, FL 32778-5252 | 2005-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487173753 | Erica Denise Irvin | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4681 Marsh Harbor Dr, Tavares, FL 32778 | 2017-09-18 |
| 1922522499 | J&t Divine Care | Home Health | 1554 Auburn Hills Ct, Tavares, FL 32778 | 2017-07-27 |
| 1841738721 | Kelli Maragh | Behavior Technician | 12237 Tavares Ridge Circle, Tavares, FL 32778 | 2017-02-10 |
| 1831633692 | Amanda Williams Sellers | Nurse Practitioner | 1858 Mayo Dr, Tavares, FL 32778 | 2016-12-13 |
| 1235680042 | Natalie Roaine Ash-maheux | Occupational Therapist | 4501 Waterman Way, Tavares, FL 32778 | 2016-10-17 |
| 1396295713 | Sumiko Burley- Collins | Community Health Worker | 1572 Auburn Hills Court, Tavares, FL 32778 | 2016-10-10 |
| 1295100980 | Sunshine Therapy Group, Pa | Speech-Language Pathologist | 2050 Classique Lane, Tavares, FL 32778 | 2015-12-06 |
| 1093188385 | Jana Michelle England | Counselor | 1300 Duncan, Tavares, FL 32778 | 2015-11-09 |
| 1467865980 | Reshma Balmick | Hearing Instrument Specialist | 500 West Burleigh Blvd., Tavares, FL 32778 | 2014-06-03 |
| 1861825739 | Shelagh Kathryn Wood-gouveia | Nurse Practitioner | 1390 East Burleigh Blvd., Tavares, FL 32778 | 2013-08-15 |
| Find all providers in zip 32778 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972658672 | Danielle M Francis | Physician Assistant | 2051 Mayo Dr, Tavares, FL 32778-4354 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598691 | Monica Nancy Ginocchio | Physician Assistant | 1020 Crosspointe Dr Ste 110, Naples, FL 34110-0918 | 2020-11-06 |
| 1427657055 | Alyson Ryall | Physician Assistant | 480 Ventura Pl, Vero Beach, FL 32963-4262 | 2020-10-24 |
| 1104436476 | Forrest Joseph Steslow | Physician Assistant | 1971 Brandywine Rd Apt 305, West Palm Beach, FL 33409-6800 | 2020-08-03 |
| 1063039576 | Joshua Bras Prewitt | Physician Assistant | 4800 Linton Blvd Ste 201, Delray Beach, FL 33445-6584 | 2020-06-30 |
| 1003443904 | Sheila Rhinehart | Physician Assistant | 981 Tarpon Ave, Sebastian, FL 32958-5147 | 2020-03-23 |
| 1952932493 | Lisel Spieler | Physician Assistant | 1173 Fins Up Ct, Daytona Beach, FL 32124-3719 | 2020-02-03 |
| 1326685991 | Nikolai X Lincavage | Physician Assistant | 29277 Us Highway 19 N # 29277, Clearwater, FL 33761-2102 | 2019-12-03 |
| 1356984686 | Zane K Jude | Physician Assistant | 1775 Linton Lake Dr, Delray Beach, FL 33445-6927 | 2019-10-18 |
| 1720635998 | Jose R Munoz | Physician Assistant | 4801 Esedra Ct Apt 203, Lake Worth, FL 33467-5019 | 2019-08-22 |
| 1811559578 | Sydney Gillen | Physician Assistant | 1222 S Orange Ave Fl 2, Orlando, FL 32806-1215 | 2019-07-02 |
| Find all providers with the same taxonomy | ||||
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| 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.