William Ennis Jr., P.A.

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

C05019 Issued in MD

Practice address

914A Eastern Shore Dr
Salisbury, MD 21804-6410

Phone

(410) 546-1331

Fax

(410) 543-8107

NPI assigned

Apr 4, 2013

Sex

Male

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 MD

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Physician Assistant

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.

• Ability Rehab Associates

  • Physical Medicine & Rehabilitation Physician
  • Salisbury, MD
  • NPI 1356444590

  MD

  Medicare reassignment
• Eastern Shore Eldercare LLC

  • Internal Medicine Physician
  • Salisbury, MD
  • NPI 1538021381

  MD

  Medicare reassignment
• Eastern Shore Medical Center PA

  • Internal Medicine Physician
  • Salisbury, MD
  • NPI 1215075890

  MD

  Medicare reassignment

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1407199706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914A EASTERN SHORE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046410",
            "telephone_number": "410-546-1331",
            "fax_number": "410-543-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914A EASTERN SHORE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046410",
            "telephone_number": "410-546-1331",
            "fax_number": "410-543-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "WILLIAM",
        "name_suffix": "Jr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-04",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MD",
            "license": "C05019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emergency Service Associates PA
• Empire Medical LLC
• Simona C Eng, DO
• Lauren Michelle Engleman, CRNP-FNP
• Aaron Ennis, BA
• Shmuel Epstein
• Jillian Sloan Erdberg, PSYD
• Paula Martin Erdie
• Erica Harrington LCSW-C
• Sentara Quiann Ernst, FNPC

• All providers in Salisbury, MD
• Surgical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.