Active NPI
Linda H Elllingson, PA-C
- Physician Assistant
- Maddock, ND
National Provider Identifier
1013015841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PAC0023
- Practice address
- 301 Roosevelt Ave
Maddock, ND 58348-7138 - Phone
- (701) 438-2555
- Fax
- (701) 438-2551
- NPI assigned
- Sep 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAC0023 | ND | Primary |
Addresses
Primary practice location
301 Roosevelt Ave
Maddock, ND 58348-7138
Mailing address
800 3Rd Ave SW
Rugby, ND 58368-1645
Phone (701) 776-5235
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| N18165 | Other | ND | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAC0023 | ND | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johnson Clinic PC | Current | Accepting new patients |
Locations
800 3rd Ave SW
Rugby, ND 58368
Phone (701) 776-5235
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Rugby, ND
- NPI 1609898600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204675200000",
"number": "1013015841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 3RD AVE SW",
"city": "RUGBY",
"state": "ND",
"postal_code": "583681645",
"telephone_number": "701-776-5235",
"fax_number": "701-776-5297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 ROOSEVELT AVE",
"city": "MADDOCK",
"state": "ND",
"postal_code": "583487138",
"telephone_number": "701-438-2555",
"fax_number": "701-438-2551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLLINGSON",
"first_name": "LINDA",
"middle_name": "H",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2008-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ND",
"license": "PAC0023",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "N18165",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maddock, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.