Active NPI
Elise Rachel Etelamaki Elegeert, PA
- Physician Assistant
- Tallahassee, FL
National Provider Identifier
1558741165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 2911 Roberts Ave
Tallahassee, FL 32310-5007 - Phone
- (850) 644-1543
- NPI assigned
- Jun 9, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
2911 Roberts Ave
Tallahassee, FL 32310-5007
Mailing address
2911 Roberts Ave
Tallahassee, FL 32310-5007
Phone (850) 644-1543
Other practice location 1
5 First Village Dr
Pinehurst, NC 28374-8724
Phone (910) 295-0290
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646956800000",
"number": "1558741165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2911 ROBERTS AVE",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323105007",
"telephone_number": "850-644-1543",
"fax_number": "850-645-2824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2911 ROBERTS AVE",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323105007",
"telephone_number": "850-644-1543"
}
],
"practiceLocations": [
{
"address_1": "5 First Village Dr",
"address_purpose": "LOCATION",
"city": "Pinehurst",
"state": "NC",
"postal_code": "283748724",
"country_code": "US",
"telephone_number": "910-295-0290",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ELEGEERT",
"first_name": "ELISE",
"middle_name": "RACHEL ETELAMAKI",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-09",
"last_updated": "2022-03-11",
"certification_date": "2022-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.