Linda Rae Ellsworth, M.D., PH.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

G4114 Issued in TX

Practice address

4499 Medical Dr
Suite 380
San Antonio, TX 78229-3735

Phone

(210) 614-3303

Fax

(210) 615-1052

NPI assigned

Nov 17, 2006

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)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528131273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR",
            "address_2": "SUITE 380",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293735",
            "telephone_number": "210-614-3303",
            "fax_number": "210-615-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4499 MEDICAL DR",
            "address_2": "SUITE 380",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293735",
            "telephone_number": "210-614-3303",
            "fax_number": "210-615-1052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "LINDA",
        "middle_name": "RAE",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "TX",
            "license": "G4114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seven Ellis
• Taylor Ellis, FNP-C
• Viviana Salom Ellis, M.D.
• Aishah Destini Ellison
• Erica Ryu Ellsworth, CCP
• Ellysse Canales DDS PC
• Nan Ellzey, LCDC
• Elm Hospice LLC
• Elm Midwifery and Womens Health LLC
• Abdelilah Elmeskyny, R.PH

• Gynecology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.