Suzanne Ellett, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05602 Issued in TX

Practice address

2005 Fort Worth Hwy Ste 200
Weatherford, TX 76086-4781

Phone

(817) 599-7661

Fax

(817) 599-8408

NPI assigned

Jan 9, 2008

Sex

Female

Sole proprietor

No

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

Physician Assistant

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445299200000",
    "number": "1568647576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 FORT WORTH HWY STE 200",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760864781",
            "telephone_number": "817-599-7661",
            "fax_number": "817-599-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 FORT WORTH HWY STE 200",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760864781",
            "telephone_number": "817-599-7661",
            "fax_number": "817-599-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLETT",
        "first_name": "SUZANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2015-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katrina Eder
• Samantha L Edwards, LPC
• Terri Jo Edwards, AU.D.
• Mark Carroll Eidson, MD
• Henry Omoikhudu Dimma Ejere, MD
• Christopher James Elliott, DDS
• Kelly Anne Ellison
• Osama Mohamed Elmhishi, MD
• Emcc Weatherford ER Physicians, PLLC
• Emcc Weatherford ER, LLC (Surepoint Emergency Center Weatherford)

• Physician Assistant in Weatherford, TX
• Providers in Weatherford, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.