Active NPI
Alyssa Christine Elleman
- Physician Assistant
- Edgewood, KY
National Provider Identifier
1316858665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 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.