Donald Dean Ellsworth, ARNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

ARNP2151382 Issued in FL

Practice address

800 Prudential Dr
Tower B, 11TH Floor
Jacksonville, FL 32207-8202

Phone

(904) 388-6518

Fax

(904) 384-1005

NPI assigned

Mar 5, 2008

Last updated

Jun 8, 2016By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Baptist Neurology Inc

  • Neurology Physician
  • Jacksonville, FL
  • NPI 1598995599
  NPD (past)

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1528238540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "address_2": "TOWER B, 11TH FLOOR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-388-6518",
            "fax_number": "904-384-1005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "address_2": "TOWER B, 11TH FLOOR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-388-6518",
            "fax_number": "904-384-1005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "DONALD",
        "middle_name": "DEAN",
        "name_prefix": "Mr.",
        "credential": "ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-05",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP2151382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "309007800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert G Ellison Jr., MD
• Eloisa Anne Ello-Esma, ARNP, FNP-BC
• Marylou V Ello, ARNP
• Joseph Ellow
• Tasha Ellsberry, APRN, FNP, PMHNP-BC
• Oday Ata Elmanaseer, MD
• Omar Elmandouh, MD
• Walneshia Elmore, HOME HEALTH AID
• Abigaile Eloissaint
• Elora Haven Home Services LLC

• Acute Care Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Acute Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; 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.