Elissa Diane Colledge, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS041316 Issued in PA

Practice address

2217 7TH Ave
Altoona, PA 16602-2243

Phone

(814) 931-9111

NPI assigned

Jun 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Windber Hospital, Inc.

  • General Acute Care Hospital
  • Windber, PA
  • NPI 1275620536
  NPD (past)

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496620800000",
    "number": "1174052047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 2ND AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166023558",
            "telephone_number": "814-232-7464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 7TH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166022243",
            "telephone_number": "814-931-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLEDGE",
        "first_name": "ELISSA",
        "middle_name": "DIANE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2017-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS041316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Coffay, NCC
• Michael Lawrence Cohen, DDS
• Jordan Coho, PA-C
• Jeffrey Charles Colbert, LCSW
• Theodore Colbert IV, DMD
• Erica College, CRNP
• Stephanie Collier, MS
• Vanessa R Colquhoun, PA-C
• Renee Ann Columbus, PA-C
• Compression Management Services, Inc.

• General Practice Dentistry in Altoona, PA
• Providers in Altoona, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.