James P. Ennis II, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

4023 Cloverland Drive
Phoenix, MD 21131-2139

Phone

(443) 514-5864

Fax

(410) 420-9641

NPI assigned

Sep 16, 2011

Last updated

Sep 16, 2011By 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

Medicare fee-for-service enrollment

Enrolled in MD

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

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennis102486@direct.umm.edu

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.

• Advanced Radiology P a

  • Diagnostic Radiology Physician
  • Owings Mills, MD
  • NPI 1932167178
  Medicare reassignment NPD
• Advanced Radiology P a

  • Diagnostic Radiology Physician
  • Columbia, MD
  • NPI 1922963776
  NPD
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316131200000",
    "number": "1598047367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4023 CLOVERLAND DRIVE",
            "city": "PHOENIX",
            "state": "MD",
            "postal_code": "211312139",
            "telephone_number": "443-514-5864",
            "fax_number": "410-420-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4023 CLOVERLAND DRIVE",
            "city": "PHOENIX",
            "state": "MD",
            "postal_code": "211312139",
            "telephone_number": "443-514-5864",
            "fax_number": "410-420-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "JAMES",
        "middle_name": "P.",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-16",
        "last_updated": "2011-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael F Diffendall, OD
• Dr Alan R Scharf DDS LLC
• Dr. Maria Yiassemides, P.a.
• Joan Patricia Edwards, MD
• Riley Elmer
• Family Foot and Ankle Care, PC
• Family Foot and Ankle Care, PC
• Magdalena Felton, NP-C
• Kerry Elisabeth Fitzpatrick, M.A. CCC-SLP
• April Christine Fogg, P.T.

• Surgical Physician Assistant in Phoenix, MD
• Providers in Phoenix, MD by specialty
• Surgical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.