Jennifer Watters Ellis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35076845 Issued in OH

Practice address

3773 Olentangy River Rd
Columbus, OH 43214-3425

Phone

(614) 566-3861

Fax

(614) 566-3835

NPI assigned

Apr 8, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ohiohealth Corporation

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1578545273
  Medicare reassignment NPD
• Ohiohealth Corporation

  • Anesthesiology Physician
  • Columbus, OH
  • NPI 1407292105
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Osu Family Practice Services

  • Federally Qualified Health Center (FQHC)
  • Columbus, OH
  • NPI 1861201535
  NPD (past)
• Valley Regional Medical Services

  • Specialist
  • Methuen, MA
  • NPI 1780675538
  NPD (past)

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1659334902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 FRANTZ RD STE 250",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430166102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3773 OLENTANGY RIVER RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432143425",
            "telephone_number": "614-566-3861",
            "fax_number": "614-566-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JENNIFER",
        "middle_name": "WATTERS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-08",
        "last_updated": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35076845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2313366",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jellis161396@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "3773 Olentangy River Rd",
            "address_2": "1st Fl",
            "city": "Columbus",
            "state": "OH",
            "country_code": "US",
            "postal_code": "432143425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emily Ellis, DO
• Hannah Ellis
• Heather Ellis
• Heather Ellis
• Jameela Ellis
• Joyce Irene Ellis
• Kelly Elizabeth Ellis, APN, CNM
• Leanna Grace Ellis, PA-C
• Marcy Ellis
• Mary Ellis

• Family Medicine Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.