Jerome Keefer Ellis, MD
Individual provider Active NPI Internal Medicine Physician · Lock Haven, PA
NPI 1568423366 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1568423366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD069228L (PA)
- Practice address
- 24 Cree Dr
Lock Haven, PA 17745-2639 - Phone
- (570) 893-5000
- NPI assigned
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exigence Pennsylvania LLC | Past | Accepting new patients | |
| Lock Haven Emergency Physicians PLLC | Internal Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD069228L | PA | Yes |
| Pediatrics Physician | 208000000X | MD069228L | PA |
Addresses
Primary practice location
24 Cree Dr
Lock Haven, PA 17745-2639
Mailing address
24 Cree Dr
Lock Haven, PA 17745-2639
Phone (570) 893-5000
Other providers in Lock Haven, PA
- J-Lin Michaela Durost
- Kayley E Edmondson
- Suzanne E Edwards
- William R Edwards
- Walter A Eisenhauer
- Morgan Euston
- Charles Albert Evans III
- Exigence Pennsylvania LLC
- Family Practice Center, PC
- Jennifer Fithian
All providers in Lock Haven, PA · Internal Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.