Elise Pacholewski, LAT, ATC

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

2015002148 Issued in MO

Practice address

501 Westminster Ave
Fulton, MO 65251-1230

Phone

(573) 592-5861

NPI assigned

Apr 21, 2016

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

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

{
    "created_epoch": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1376997726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 W BROADWAY",
            "address_2": "APT 110",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652031270",
            "telephone_number": "216-310-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WESTMINSTER AVE",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511230",
            "telephone_number": "573-592-5861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHOLEWSKI",
        "first_name": "ELISE",
        "credential": "LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-21",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2015002148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noble Health Fulton Inc
• Megan O'Grady, PSYD
• Gina M Oliver, FNP-BC
• Richard M Omohundro, D.D.S.
• Katherine Louise Osborn, OD
• Elizabeth Panicker
• Alicia Pardee
• Andrew Paul Patel, M.D.
• Jennifer Michele Patrick, LCSW
• Hunter Lee Patterson, MD, PHD, MBA

• Student in an Organized Health Care Education/Training Program in Fulton, MO
• Providers in Fulton, MO by specialty
• Student in an Organized Health Care Education/Training Program in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; 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.