John Elloway MD a Professional Corp

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ZZZ24941Z Issued in CA

Legal business name

JOHN ELLOWAY MD A PROFESSIONAL CORP

Doing business as

n/a

Practice address

1324 Grant Ave
Novato, CA 94945-3152

Phone

(415) 892-3300

Fax

(415) 897-0079

NPI assigned

Mar 21, 2008

Last updated

Nov 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Elloway, M.D.

Title

Director

Phone

(415) 892-3300

Specialties & licenses 1

Addresses

Other names 1

• n/a Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Natalie Arlene Summerlin, FNP

  • Family Nurse Practitioner
  • Tulsa, OK
  • NPI 1023006343
  NPD (past)

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1174794770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 GRANT AVE",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949453152",
            "telephone_number": "415-892-3300",
            "fax_number": "415-897-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 GRANT AVE",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949453152",
            "telephone_number": "415-892-3300",
            "fax_number": "415-897-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN ELLOWAY MD A PROFESSIONAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-21",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "ELLOWAY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "415-892-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "ZZZ24941Z",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Ann Jernberg
• Suzanne Jessup
• Deidre Jimenez
• Michele Jodoin, PA
• Joel S. Erickson, M.D., Inc. (Laser Light Treatment Center)
• Jashaun Johnson
• Melanie Johnson, PH.D.
• Amanda Mallory Jones, RN
• Christopher Joel Jones
• Dallas Jones

• Primary Care Clinic/Center in Novato, CA
• Providers in Novato, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.