Jawaneka P Ellerson, AG NPC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AG0117043 Issued in AL

Practice address

2900 McGehee Rd
Montgomery, AL 36111-2151

Phone

(334) 280-3349

Fax

(334) 281-2308

NPI assigned

Mar 23, 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 AL

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Alabama AIDS Outreach IncGroup PAC ID 7517212376, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jawaneka.ellerson.1@30992.direct.athenahealth.com

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.

• West Alabama AIDS Outreach Inc

  • General Practice Physician
  • Tuscaloosa, AL
  • NPI 1619731361
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1396276127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11087",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361110087",
            "telephone_number": "334-481-1599",
            "fax_number": "334-281-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 MCGEHEE RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361112151",
            "telephone_number": "334-280-3349",
            "fax_number": "334-281-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLERSON",
        "first_name": "JAWANEKA",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "AG NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "AG0117043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Healthcare Training Academy LLC
• Elite Home Care Agency LLC
• Elite Rehab Inc
• Elite Support & Logistics LLC
• Gail Ellerbrake
• Clarita Ellington, OTR
• Eraya Ellington
• Eryka Ellington
• Darin Lamar Elliott, PHARMD
• Emily Elliott, FNP-C

• Gerontology Nurse Practitioner in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Gerontology Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.