Individual provider Active NPI

Alyssa Christine Elleman

  • Physician Assistant
  • Edgewood, KY
National Provider Identifier
1316858665
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 Medical Village Dr
Edgewood, KY 41017-3403
Phone
(859) 301-2250
NPI assigned
Sep 15, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X KY Primary

Addresses

Primary practice location

1 Medical Village Dr
Edgewood, KY 41017-3403

Mailing address

PO Box 18667
Erlanger, KY 41018-0667
Phone (859) 572-3617

Other practice location 1

4900 Houston Rd
Florence, KY 41042-4824
Phone (859) 212-5441

Other practice location 2

85 N Grand Ave
Fort Thomas, KY 41075-1793
Phone (859) 572-3618

Other practice location 3

1500 James Simpson Jr Way
Covington, KY 41011-0801
Phone (859) 655-4353

Other practice location 4

238 Barnes Rd
Williamstown, KY 41097-9482
Phone (859) 824-8240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1789430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1316858665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18667",
            "city": "ERLANGER",
            "state": "KY",
            "postal_code": "410180667",
            "telephone_number": "859-572-3617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DR",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-2250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Houston Rd",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "KY",
            "postal_code": "410424824",
            "country_code": "US",
            "telephone_number": "859-212-5441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 N Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Thomas",
            "state": "KY",
            "postal_code": "410751793",
            "country_code": "US",
            "telephone_number": "859-572-3618",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 James Simpson Jr Way",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "KY",
            "postal_code": "410110801",
            "country_code": "US",
            "telephone_number": "859-655-4353",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "238 Barnes Rd",
            "address_purpose": "LOCATION",
            "city": "Williamstown",
            "state": "KY",
            "postal_code": "410979482",
            "country_code": "US",
            "telephone_number": "859-824-8240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLEMAN",
        "first_name": "ALYSSA",
        "middle_name": "CHRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-15",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.