COLEEN ANN ELLIS (NPI# 1366416190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366416190 |
Entity Type | Individual |
Full Name | COLEEN ANN ELLIS |
Credential | MD |
Practice Address |
1120 10th St E Palmetto FL 34221-4134 |
Mailing Address |
10051 5th St N Ste 200 St Petersburg FL 33702-2211 |
Practice Telephone | 9418477903 |
Practice Fax Number | 9418477919 |
Mailing Telephone | 7278240780 |
Mailing Fax Number | 7275686011 |
Enumeration Date | 2006-02-16 |
Last Update Date | 2020-09-02 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | ME87898 | FL | Allopathic & Osteopathic Physicians |
N | 207R00000X | Internal Medicine | ME87898 | FL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 271958400 | 05 |
Street Address |
1120 10TH ST E |
City | PALMETTO |
State | FL |
Zip Code | 34221-4134 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841524048 | Josephine Richardson Polch | Nurse Practitioner | 1120 10th St E, Palmetto, FL 34221-4134 | 2009-09-22 |
1194953695 | Suzanne Sandra Johnson | Family Medicine | 1120 10th St E, Palmetto, FL 34221-4134 | 2009-06-23 |
1649224114 | Katia M Adams | Family Medicine | 1120 10th St E, Palmetto, FL 34221-4134 | 2006-05-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891355418 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 9520 Buffalo Road, Palmetto, FL 34221 | 2019-06-17 |
1326571514 | Jacquelyn Marques | Behavioral Analyst | 615 Riviera Dunes Way, Apt. #307, Palmetto, FL 34221 | 2017-04-05 |
1821539883 | Amy Nicole Charles | Contractor | 1603 72nd St. Ct. East, Palmetto, FL 34221 | 2017-03-10 |
1295045946 | Garcia Optometric Corp | Optometrist | 508 10th Street East, Palmetto, FL 34221 | 2010-10-15 |
1669668273 | Diamond Family Medicine Pllc Donita Kay Diamond Sole Mbr | Family Medicine | 102 Riviera Dunes Way, Palmetto, FL 34221 | 2007-09-18 |
1699970731 | J Scott Maloney | Dentist | 317 7th St W, Palmetto, FL 34221 | 2007-06-19 |
1669687612 | Eli Kolp | Psychiatry & Neurology | 1604 3rd Street Cir E, Palmetto, FL 34221 | 2007-05-13 |
1134341548 | Amanda L Nevin | Dentist | 707 7th Street West, Palmetto, FL 34221 | 2007-05-03 |
1669697298 | Jessica Ann Stellaci | Physical Therapist | The Kidspot 410 10th Ave W., Palmetto, FL 34221 | 2007-04-17 |
1417069261 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 627 10th Street East, Palmetto, FL 34221 | 2006-08-31 |
Find all providers in zip 34221 |
Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699318840 | Palmetto Primary Care Associates, LLC | Family Medicine | 1003 17th St W, Palmetto, FL 34221-3021 | 2019-10-21 |
1326465410 | Allcare Options LLC | Family Medicine | 700 8th Ave W, Suite 101, Palmetto, FL 34221-4737 | 2014-03-26 |
1073771762 | Jacqueline D Harris | Family Medicine | 815 Weldon Rd, Palmetto, GA 30268-1667 | 2008-05-29 |
1669668273 | Diamond Family Medicine Pllc Donita Kay Diamond Sole Mbr | Family Medicine | 102 Riviera Dunes Way, Palmetto, FL 34221 | 2007-09-18 |
1104968783 | Kevin Brian Fox | Family Medicine | 9490 Highway 10, Palmetto, LA 71358-0219 | 2007-02-12 |
1851369052 | Steven Lewis Greenfield | Family Medicine | 404 7th St W, Palmetto, FL 34221-5209 | 2006-03-14 |
1194722983 | James A Briles | Family Medicine | 606 4th Ave W, Palmetto, FL 34221-5226 | 2005-07-07 |
1558368423 | Raymond L Raitz | Family Medicine | 506 4th Ave W, Palmetto, FL 34221-5203 | 2005-07-06 |
1740823582 | Mcr Health, Inc. | Family Medicine | 700 8th Ave W Ste 101, Palmetto, FL 34221-4737 | 2019-10-24 |
1215323100 | Rosanna Elena Ianiro | Family Medicine | 606 4th Ave W, Palmetto, FL 34221-5226 | 2015-04-08 |
Find all providers in PALMETTO |
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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.