KOBE ELLIS (NPI# 1881992030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881992030 |
| Entity Type | Individual |
| Full Name | KOBE ELLIS |
| Other Name | KOBE ELLIS |
| Credential | KOBE ELLIS |
| Practice Address |
3745 Southside Blvd Jacksonville FL 32216-4637 |
| Mailing Address |
1967 Sussex Dr N Orange Park FL 32073-5917 |
| Practice Telephone | 9045685242 |
| Mailing Telephone | 9045685242 |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
| Street Address |
3745 SOUTHSIDE BLVD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-4637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407318397 | Universal Design Solutions LLC | Durable Medical Equipment & Medical Supplies | 11555 Central Pkwy Ste 1002, Jacksonville, FL 32224-2702 | 2019-04-01 |
| 1700311065 | National Seating & Mobility, Inc | Durable Medical Equipment & Medical Supplies | 11651 Central Pkwy Ste 121, Jacksonville, FL 32224-2709 | 2017-04-25 |
| 1790233385 | Coastal Carolina Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 1715 Country Club Rd Ste B, Jacksonville, NC 28546-6042 | 2016-09-13 |
| 1548500911 | Wayne's 1/2 Price Bedding | Durable Medical Equipment & Medical Supplies | 5853 Normandy Blvd, Jacksonville, FL 32205-6252 | 2013-02-22 |
| 1598062978 | Mitchell R Levine Dmd Pa | Durable Medical Equipment & Medical Supplies | 3600 Cardinal Point Dr, Jacksonville, FL 32257-5581 | 2011-02-20 |
| 1689983397 | Menrx Surgical, LLC | Durable Medical Equipment & Medical Supplies | 10302 Deerwood Park Blvd, Suite 209, Jacksonville, FL 32256-2880 | 2010-09-29 |
| 1447586466 | Wng LLC | Durable Medical Equipment & Medical Supplies | 7667 W Beaver St Lot 5, Jacksonville, FL 32220-3601 | 2009-10-27 |
| 1134249410 | Mandarin Eyecare Assoc, Inc | Durable Medical Equipment & Medical Supplies | 11111 San Jose Blvd, Suite 44, Jacksonville, FL 32223-7946 | 2007-03-30 |
| 1720007610 | Realo Discount Drug Stores of Eastern North Carolina, Inc. | Durable Medical Equipment & Medical Supplies | 2680 Henderson Dr, Unit 1, Jacksonville, NC 28546-5296 | 2006-07-19 |
| 1700856457 | Home Medical Systems Inc | Durable Medical Equipment & Medical Supplies | 13 Doris Ave E, Suite C, Jacksonville, NC 28540-5149 | 2006-01-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
Please comment or provide details below to improve the information on KOBE ELLIS.
| 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.