Rebecca Ann Ellsworth, RDH, COM

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

2902005366 Issued in MI

Practice address

1011 W Maple St
Suite 300
Kalamazoo, MI 49008-1899

Phone

(269) 343-7811

NPI assigned

Dec 8, 2011

Sex

Female

Sole proprietor

Yes

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.

• Kalamazoo Speech Associates

  • Hearing and Speech Clinic/Center
  • Kalamazoo, MI
  • NPI 1558019406
  NPD (past)
• Kalamazoo Speech Associates, Inc.

  • Speech-Language Pathologist
  • Kalamazoo, MI
  • NPI 1558785451
  NPD (past)

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1356619084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 W MAPLE ST",
            "address_2": "SUITE 300",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081899",
            "telephone_number": "269-343-7811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 W MAPLE ST",
            "address_2": "SUITE 300",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490081899",
            "telephone_number": "269-343-7811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RDH, COM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "MI",
            "license": "2902005366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia Ellis, PA
• Jeannie Ellison, CPHT
• Renay Ellison, LMSW
• Susan D Ellison, RN
• Maria Ellsworth
• Joshua Peter Ellwitz, MD
• Stephanie Ann Ellwood, D.O.
• Dani J Elmore
• Kaylee Elmore
• Dean Elnaas, RPH

• Dental Hygienist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Dental Hygienist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.