ELLEN DAVIS (NPI# 1194384362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194384362 |
Entity Type | Individual |
Full Name | ELLEN DAVIS |
Practice Address |
130 Pablo St Lakeland FL 33803-3818 |
Mailing Address |
1324 Lakeland Hills Blvd Managed Care Dept Lakeland FL 33805-4543 |
Practice Telephone | 8632845906 |
Practice Fax Number | 8632845149 |
Enumeration Date | 2019-06-11 |
Last Update Date | 2019-11-13 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9112245 | FL | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831645977 | Ellen Davis | Massage Therapist | 3302 Fuhrman Ave E, Ste 110, Seattle, WA 98102-7115 | 2016-08-29 |
1043607021 | Ellen Davis | Specialist/Technologist | 11319 Kings Valley Dr, Damascus, MD 20872-2259 | 2015-04-17 |
1376734368 | Ellen Jean Davis | Internal Medicine | 2715 Sw Willetta, Suite B, Albany, OR 97321 | 2007-08-06 |
1053465179 | Ellen C Davis | Occupational Therapist | 205 South St E, Talladega, AL 35160-2411 | 2007-01-23 |
1366439093 | Ellen Satterwhite Davis | Pediatrics | 705 Summit Crossing Pl, Suite 150, Gastonia, NC 28054-2137 | 2005-09-27 |
1861987372 | Ellen L Davis | Counselor | 195 N Grant Ave Ste 250, Columbus, OH 43215-2855 | 2018-06-27 |
1346749686 | Ellen Davis | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2018-02-01 |
1235526005 | Ellen Geheber Davis | Acupuncturist | 11965 Venice Blvd, Suite 407, Los Angeles, CA 90066-3979 | 2015-04-20 |
1598162828 | Ellen S Davis | Community Health Worker | 325 Sw Frazier Ave, Topeka, KS 66606-1963 | 2014-12-02 |
1487063970 | Ellen Latoya Davis | Counselor | 850 E Foothill Blvd, Rialto, CA 92376-5230 | 2014-08-08 |
Street Address |
130 PABLO ST |
City | LAKELAND |
State | FL |
Zip Code | 33803-3818 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003810672 | Andrea Beale | Nurse Practitioner | 130 Pablo St, Lakeland, FL 33803-3818 | 2005-06-10 |
1740804673 | Brian Win | Physician Assistant | 130 Pablo St, Lakeland, FL 33803-3818 | 2020-06-06 |
1285284216 | Sandra Baffoe-bonnie | Nurse Practitioner | 130 Pablo St, Lakeland, FL 33803-3818 | 2019-09-11 |
1215586458 | Jillian Railey | Nurse Practitioner | 130 Pablo St, Lakeland, FL 33803-3818 | 2019-09-10 |
1558827592 | Rebecca N Levine | Physician Assistant | 130 Pablo St, Lakeland, FL 33803-3818 | 2019-02-14 |
1124594007 | Rany Najeh Ahmad | Nurse Practitioner | 130 Pablo St, Lakeland, FL 33803-3818 | 2018-10-18 |
1093224206 | Moezza Butler | Registered Nurse | 130 Pablo St, Lakeland, FL 33803-3818 | 2017-09-20 |
1679092050 | Jessica Polk | Internal Medicine | 130 Pablo St, Lakeland, FL 33803-3818 | 2017-09-16 |
1750803201 | Mary L Roy | Nurse Practitioner | 130 Pablo St, Lakeland, FL 33803-3818 | 2017-07-15 |
1275053662 | Taccara Willis | Nurse Practitioner | 130 Pablo St, Lakeland, FL 33803-3818 | 2017-06-27 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861964819 | Steven P Agelidis | Counselor | 2020 S. Florida Ave, Suite 207, Lakeland, FL 33803 | 2018-12-31 |
1902316201 | Kesara Mai Ngam | Massage Therapist | 117 West Oak Drive, Lakeland, FL 33803 | 2017-10-02 |
1396260618 | Suncoast Behavioral Solutions, LLC | Behavioral Analyst | 1920 E Edgewood Dr Apt A8, Lakeland, FL 33803 | 2017-08-08 |
1316484413 | Daniel Jacob Stahl | Behavior Technician | 145 East Edgewood Drive, Lakeland, FL 33803 | 2017-01-26 |
1780037002 | Shelley Stettinius | Behavioral Analyst | 145 East Edgewood Dr, Lakeland, FL 33803 | 2016-07-21 |
1396106654 | Highlands Occupational Therapy, Inc | Occupational Therapist | 2000 East Edgewood Drive, Suite 114, Lakeland, FL 33803 | 2016-03-15 |
1003289570 | Jayna Dinsmore | Physical Therapy Assistant | 321 Imperial Blvd, D38, Lakeland, FL 33803 | 2015-11-05 |
1093187429 | Healthstat Wellness Polk-lakeland | Preventive Medicine | 3215 Winter Lake Road, Lakeland, FL 33803 | 2015-10-26 |
1962812545 | Florida Presbyterian Homes, Inc | Nursing Facility/Intermediate Care Facility | 901 Lakeside Avenue, Lakeland, FL 33803 | 2014-05-05 |
1710316336 | Trinity Endodontics | Health Maintenance Organization | 1602 S. Florida Ave, Ste #1, Lakeland, FL 33803 | 2013-11-04 |
Find all providers in zip 33803 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760758643 | Sunshine Assistant LLC | Physician Assistant | 6308 Prominence Point Drive, Lakeland, FL 33813-4491 | 2012-03-26 |
1134779812 | Mallory Bastian | Physician Assistant | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3065 | 2019-09-16 |
1992354948 | Joseph Carmine Randazzo Jr. | Physician Assistant | 1324 Lakeland Hills Blvd, Attn: Managed Care Depot, Lakeland, FL 33805-4543 | 2019-09-11 |
1659740835 | Laura Zambetti | Physician Assistant | 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 | 2015-09-17 |
1528480480 | Jessica Lyons | Physician Assistant | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3019 | 2014-01-13 |
1447502828 | Weslyn A Leffler | Physician Assistant | 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 | 2012-10-09 |
1689940934 | Kyle Merritt | Physician Assistant | 1818 Harden Blvd, Suite 120, Lakeland, FL 33803-1812 | 2012-03-30 |
1689945693 | Seth D Gardner | Physician Assistant | 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 | 2012-01-23 |
1528357183 | Megan E Fincham | Physician Assistant | 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 | 2011-04-05 |
1750538294 | Janet Faith Mccabe | Physician Assistant | 1324 Lakeland Hills Blvd, Lakeland, FL 33805-4543 | 2008-08-27 |
Find all providers in LAKELAND |
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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.