VANESSA LYNN ELLEDGE (NPI# 1467675454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467675454 |
| Entity Type | Individual |
| Full Name | VANESSA LYNN ELLEDGE |
| Credential | P.A.-C |
| Practice Address |
22710 Professional Dr Suite 202 Kingwood TX 77339-6008 |
| Practice Telephone | 2813128521 |
| Practice Fax Number | 2813597971 |
| Mailing Telephone | 2813128521 |
| Mailing Fax Number | 2813597971 |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2012-10-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA04602 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | LICENSE | PA04602 | 01 |
| Street Address |
22710 PROFESSIONAL DR SUITE 202 |
| City | KINGWOOD |
| State | TX |
| Zip Code | 77339-6008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164425211 | Mary K Crow | Internal Medicine | 22710 Professional Dr, Kingwood, TX 77339-6008 | 2005-05-23 |
| 1740732932 | Gayle Gordon | Nurse Practitioner | 22710 Professional Dr, Suite 203, Kingwood, TX 77339-6008 | 2016-11-04 |
| 1558763060 | Deanna Marie Camacho | Nurse Practitioner | 22710 Professional Dr, Suite 203, Kingwood, TX 77339-6008 | 2014-09-16 |
| 1114335775 | Millennium Physicians Associaton, Pllc | Nurse Practitioner | 22710 Professional Dr, Suite 203, Kingwood, TX 77339-6008 | 2014-07-28 |
| 1710231261 | Shannon Marie Johnson | Nurse Practitioner | 22710 Professional Dr, Suite 201, Kingwood, TX 77339-6008 | 2012-11-06 |
| 1114086063 | Craig A. Kovitz | Internal Medicine | 22710 Professional Dr, Kingwood, TX 77339-6008 | 2006-12-07 |
| 1972670032 | Hazel J Heddings | Family Medicine | 22710 Professional Dr, Kingwood, TX 77339 | 2006-11-30 |
| 1033141569 | Nimi L Tuamokumo | Radiology | 22710 Professional Dr, Radiation Department, Kingwood, TX 77339-6008 | 2006-07-07 |
| 1801851225 | Salvador Rafael Recio | Internal Medicine | 22710 Professional Dr, Suite 203, Kingwood, TX 77339-6008 | 2006-04-19 |
| 1730142068 | Murtaza N Bhuriwala | Internal Medicine | 22710 Professional Dr, Kingwood, TX 77339-6008 | 2006-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851913669 | Robert Rowlands | Student in an Organized Health Care Education/Training Program | 22999 Us Hwy 59 N, Kingwood, Tx, 77339, Kingwood, TX 77339 | 2020-05-14 |
| 1295356467 | Christopher Dilger | Student in an Organized Health Care Education/Training Program | 22999 Us Hwy 59 N, Gme Suite 105, Kingwood, TX 77339 | 2020-04-29 |
| 1427600337 | Lynda Nguyen | Nurse Practitioner | 24006 Highway 59 N, Kingwood, TX 77339 | 2019-07-11 |
| 1215599139 | H-e-b, Lp | Clinical Medical Laboratory | 19529 Northpark Drive, Kingwood, TX 77339 | 2019-07-01 |
| 1639631492 | Trung Nguyen | Student in an Organized Health Care Education/Training Program | 22999 Us 59 N, Kingwood, TX 77339 | 2019-04-02 |
| 1467913673 | Bhavin G Shah | Student in an Organized Health Care Education/Training Program | 22999 Us-59 N, Kingwood, Tx 77339, Kingwood, TX 77339 | 2019-03-29 |
| 1164999462 | Erica Peters | Behavior Technician | 2825 W. Town Center Circle, Kingwood, TX 77339 | 2018-10-25 |
| 1780162040 | Kaldan Inc | Dentist | 23812 Hwy 59 North, Kingwood, TX 77339 | 2018-07-30 |
| 1457845745 | John Micheal Leondike | Nurse Practitioner | 2665 Royal Forrest Dr., Ste B-150, Kingwood, TX 77339 | 2018-06-19 |
| 1780173161 | Pta Home Health Care | Home Health | 5606 Rocky Trail Dr, Kingwood, TX 77339 | 2018-05-01 |
| Find all providers in zip 77339 | ||||
| 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 |
|---|---|---|---|---|
| 1306316054 | Kathryn Marie Copeland | Physician Assistant | 1815 Winter Grape Ln, Kingwood, TX 77345-2506 | 2018-11-26 |
| 1144708256 | Elsa Kristel Castrejon Garza | Physician Assistant | 1849 Kingwood Dr Ste 105, Kingwood, TX 77339-2974 | 2018-07-31 |
| 1306148036 | Gayla Lizabeth Murphy | Physician Assistant | 5414 Sycamore Creek Dr, Kingwood, TX 77345-1449 | 2010-12-01 |
| 1871799809 | Dyron Everette Powell Sr. | Physician Assistant | 3036 North Park Drive, Kingwood, TX 77339 | 2007-06-26 |
| 1659429330 | Gregory John Bromund | Physician Assistant | 510 Trail Springs Ct, Kingwood, TX 77339-4488 | 2007-01-08 |
| 1144266388 | Jennifer Richey | Physician Assistant | 451 Kingwood Medical Drive, Suite 200, Kingwood, TX 77339 | 2006-06-22 |
| 1891769063 | Timothy A Bolyard | Physician Assistant | 411 Morgantown St, Kingwood, WV 26537 | 2006-02-15 |
| 1922093319 | Diana Katherine Clark-mcgill | Physician Assistant | 1450 Kingwood Dr, Kingwood, TX 77339-3040 | 2005-09-13 |
| 1548254907 | Nancy Louise Jones | Physician Assistant | 150 Memorial Dr, Kingwood, WV 26537-1141 | 2005-08-31 |
| 1760081368 | April Ruggiano | Physician Assistant | 3411 Cedar Knolls Dr Ste B, Kingwood, TX 77339-2474 | 2020-10-23 |
| Find all providers in KINGWOOD | ||||
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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.