DR. ROBERT G ELLISON JR. (NPI# 1477571008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477571008 |
| Entity Type | Individual |
| Full Name | DR. ROBERT G ELLISON JR. |
| Credential | MD |
| Practice Address |
836 Prudential Dr Suite 1405 Jacksonville FL 32207-8334 |
| Practice Telephone | 9043887521 |
| Practice Fax Number | 9043883541 |
| Mailing Telephone | 9043887521 |
| Mailing Fax Number | 9043883541 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
ME39556 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407138837 | Robert P Ellison | Dentist | 615 Professional Park Dr, New Haven, IN 46774-1850 | 2011-09-12 |
| 1285290395 | Robert Andrew Ellison | Registered Nurse | 4000 Laurel St, Anchorage, AK 99508-5333 | 2019-05-14 |
| 1245725035 | Robert Ellison | Dentist | 113 Harbor Town Sq Ste 203, Memphis, TN 38103-8890 | 2018-06-25 |
| 1982117453 | Robert Jeffrey (jeff) Ellison | Counselor | 2 Station Way Rd, Chadds Ford, PA 19317-9782 | 2017-11-07 |
| 1285026302 | Robert Brian Ellison | Counselor | 1664 Broadway, El Cajon, CA 92021-5201 | 2015-02-26 |
| 1265526412 | Robert J Ellison | Psychologist | 1601 Highway 13 E, Ste. 101, Burnsville, MN 55337-6865 | 2006-10-03 |
| 1841309762 | Robert Stanfill Ellison | Specialist | 614 Howard Street, Asu Student Health Service, Boone, NC 28607 | 2006-08-30 |
| 1275570475 | Robert C Ellison | Preventive Medicine | 88 East Newton Street, Boston Med Ctr B-612, Roxbury, MA 02118 | 2006-05-31 |
| 1508832114 | Robert J Ellison | Physical Therapist | 2488 E 81st St Ste 290, Tulsa, OK 74137-4265 | 2006-02-23 |
| 1265425714 | Robert L Ellison | Anesthesiology | 2300 W A St, Moscow, ID 83843-4038 | 2005-08-30 |
| Street Address |
836 PRUDENTIAL DR SUITE 1405 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063416550 | Joseph David Allen | Physician Assistant | 836 Prudential Dr, Suite 801, Jacksonville, FL 32207-8334 | 2005-06-13 |
| 1245877513 | Monica Pombier | Nurse Practitioner | 836 Prudential Dr, Jacksonville, FL 32207 | 2019-12-05 |
| 1396110581 | Jena Joray Snipes | Nurse Practitioner | 836 Prudential Dr, Ste 1405, Jacksonville, FL 32207-8334 | 2015-12-14 |
| 1801266754 | Melanie Barriger Wilson | Nurse Practitioner | 836 Prudential Dr, Suite 1405, Jacksonville, FL 32207-8334 | 2015-10-05 |
| 1477932002 | Maggie Davis | Nurse Practitioner | 836 Prudential Dr, Suite 1800, Jacksonville, FL 32207-8334 | 2015-05-28 |
| 1114306024 | Baptist Ent Specialists Inc | Otolaryngology | 836 Prudential Dr, Suite 1601, Jacksonville, FL 32207-8334 | 2015-05-26 |
| 1811375918 | Candice Joy Stephenson | Physician Assistant | 836 Prudential Dr, Suite 1601, Jacksonville, FL 32207-8334 | 2015-05-11 |
| 1467882340 | Molly Mckee Turner | Nurse Practitioner | 836 Prudential Dr, Suite 1103, Jacksonville, FL 32207-8334 | 2013-11-14 |
| 1285907311 | Baptist Cardiology, Inc. | Internal Medicine | 836 Prudential Dr, Suite 1700, Jacksonville, FL 32207-8334 | 2012-02-21 |
| 1689962375 | Angela Marie Kaeding | Nurse Practitioner | 836 Prudential Dr, 1800, Jacksonville, FL 32207-8334 | 2011-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972882777 | Michael Jos Sweeney | Surgery | 2917 Grand Ave, Jacksonville, FL 32210-4405 | 2011-08-10 |
| 1780068460 | Surgery Clinic, LLC | Surgery | 320 Branscomb Dr Sw, Suite B, Jacksonville, AL 36265-3101 | 2015-07-13 |
| 1417210717 | Adil Arshad Khan | Surgery | 3599 University Blvd S, Ste 602, Jacksonville, FL 32216 | 2012-06-21 |
| 1518257674 | Jared Todd Feyko | Surgery | 836 Prudential Dr, Ste 1804, Jacksonville, FL 32207 | 2011-04-11 |
| 1972795755 | Sara E Clark | Surgery | 1824 King St, Ste 200, Jacksonville, FL 32204-4735 | 2007-08-15 |
| 1578780672 | Houssam Farres | Surgery | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2007-04-19 |
| 1922028026 | Danny H Vo | Surgery | 3599 University Blvd S, Ste 602, Jacksonville, FL 32216 | 2006-07-20 |
| 1831174044 | Jon Christian Allmon | Surgery | 1824 King St, Ste 200, Jacksonville, FL 32204 | 2005-12-09 |
| 1124018924 | Albert Hakaim | Surgery | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2005-10-24 |
| 1922098623 | Warner Oldenburg | Surgery | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2005-10-24 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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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.