NPIMap

Organization Active NPI

Suzanne E Ellison MD Professional Association

  • Family Medicine Physician
  • Fredericksburg, TX
National Provider Identifier
1548447923
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUZANNE E ELLISON MD PROFESSIONAL ASSOCIATION
Practice address
200 W Windcrest St
Fredericksburg, TX 78624-4408
Phone
(830) 997-0330
NPI assigned
Jan 28, 2008
Last updated
Jan 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Suzanne Ellison, MDNPI 1285620211
Title
President
Phone
(830) 997-0330

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

200 W Windcrest St
Fredericksburg, TX 78624-4408

Mailing address

200 W Windcrest St
Fredericksburg, TX 78624-4408
Phone (830) 997-0330

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1548447923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W WINDCREST ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244408",
            "telephone_number": "830-997-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W WINDCREST ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244408",
            "telephone_number": "830-997-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUZANNE E ELLISON MD PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "830-997-0330",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.