Jesica Lyn Ellison, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN232412 Issued in GA

Practice address

2335 Limestone Overlook
Gainesville, GA 30501-7443

Phone

(770) 297-0356

Fax

(770) 297-7564

NPI assigned

Aug 25, 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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lanier Interventional Pain Center, LLC

  • Interventional Pain Medicine Physician
  • Gainesville, GA
  • NPI 1528041803
  Medicare reassignment NPD
• Lanier Interventional Pain Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Gainesville, GA
  • NPI 1669700241
  NPD

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

{
    "created_epoch": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194242636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 LIMESTONE OVERLOOK",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017443",
            "telephone_number": "770-297-0356",
            "fax_number": "770-297-7564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 LIMESTONE OVERLOOK",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017443",
            "telephone_number": "770-297-0356",
            "fax_number": "770-297-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "JESICA",
        "middle_name": "LYN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN232412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adnan Elhammali
• Brandon Lee Ellis, PA-C
• Ezra Daniel Ellis, M.D.
• Ashlyn Ellison
• Elizabeth F Ellison, OD
• Stephen Ellison, O.D.
• Stephen Merle Elmore, MD
• Jessica Emmett, LPC, CACII
• Jerri Emory, SA-C
• Bryan Scott Engel, NP-C

• Family Nurse Practitioner in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.