Elissa Ermmarino, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2013-01436 Issued in NC

Practice address

620 Farm Life Ave
Vanceboro, NC 28586-7673

Phone

(252) 244-1785

Fax

(252) 244-2876

NPI assigned

Dec 29, 2006

Last updated

Mar 17, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Dr. Elissa Schlichter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Great Harbor Family & Sports Medicine, Inc

  • General Practice Physician
  • San Pedro, CA
  • NPI 1962629162
  NPD (past)
• Whitaker Wellness Institute Medical Clinic Inc

  • Clinical Medical Laboratory
  • Newport Beach, CA
  • NPI 1073761466
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1114083466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 896206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282896206",
            "telephone_number": "252-244-1785",
            "fax_number": "252-244-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 FARM LIFE AVE",
            "city": "VANCEBORO",
            "state": "NC",
            "postal_code": "285867673",
            "telephone_number": "252-244-1785",
            "fax_number": "252-244-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERMMARINO",
        "first_name": "ELISSA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7368",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "212592",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2013-01436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA MEDICAL LICENSE",
            "identifier": "20A7368",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH CAROLINA MEDICAL BOARD",
            "identifier": "2013-01436",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK MEDICAL LICENSE",
            "identifier": "212592",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISSA",
            "last_name": "SCHLICHTER",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sara Brame, RPH
• Carolina East Physicians
• Carolinaeast Medical Center (CarolinaEast Primary Care)
• Choices Group Home, Inc.
• Desiree Townsend Davis, AGPCNP
• Victoria Ashley Gent, RN
• Guided Hands Nursing, PLLC
• Ernest G Hargett, BS RPH
• Hygeia, Inc. (Vanceboro Pharmacy)
• Linda M Jackson, MA ED, LPC

• Family Medicine Physician in Vanceboro, NC
• Providers in Vanceboro, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; 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.