Individual provider Active NPI

Jessica Jeanne McElhose, NNP

  • Critical Care Neonatal Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1013196310
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
NP95012326 Issued in CA
Practice address
3010 Childrens Way
San Diego, CA 92123-4223
Phone
(858) 966-5818
NPI assigned
Nov 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X AP60037772 WA
Critical Care Neonatal Nurse Practitioner 363LN0005X NP95012326 CA Primary

Addresses

Primary practice location

3010 Childrens Way
San Diego, CA 92123-4223

Mailing address

3020 Childrens Way # Mc5008
San Diego, CA 92123-4223
Phone (858) 966-5818

Other practice location 1

2185 Citracado Pkwy
Escondido, CA 92029-4159
Phone (442) 282-3193

Other identifiers 4

IdentifierTypeStateIssuer
8949510OtherWALABOR & INDUSTRIES CRIME VICTIMS
00043791-00MedicaidFL
9659434MedicaidWA
003118865AMedicaidGA

Other names 1

  • Jessica Jeanne Fry Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP95012326CAMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego PastSince Jun 6, 2021 Accepting new patients
Marilyn Kaufhold, M.D., a Medical Corporation PastSince Jun 6, 2021 Accepting new patients
Children'S Hospital Pediatric Associates, Inc PastSince Jun 6, 2021 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1013196310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 CHILDRENS WAY # MC5008",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 CHILDRENS WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234223",
            "telephone_number": "858-966-5818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2185 Citracado Pkwy",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920294159",
            "country_code": "US",
            "telephone_number": "442-282-3193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCELHOSE",
        "first_name": "JESSICA",
        "middle_name": "JEANNE",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-02",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "WA",
            "license": "AP60037772",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "CA",
            "license": "NP95012326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES CRIME VICTIMS",
            "identifier": "8949510",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00043791-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9659434",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003118865A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "FRY",
            "middle_name": "JEANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.