Active NPI
Ellen Andrews Ovson, MD
- Internal Medicine Physician
- Jacksonville, FL
National Provider Identifier
1700829827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME133564
- Practice address
- 1900 Corporate SQ Blvd
Jacksonville, FL 32216 - Phone
- (904) 855-4364
- Fax
- (904) 661-3757
- NPI assigned
- Jun 14, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Internal Medicine) Physician | 207RA0401X | 4183 | AL | |
| Addiction Medicine (Psychiatry & Neurology) Physician | 2084A0401X | 18338 | MS | |
| Internal Medicine Physician | 207R00000X | ME133564 | FL | Primary |
Addresses
Primary practice location
1900 Corporate SQ Blvd
Jacksonville, FL 32216
Mailing address
1900 Corporate SQ Blvd
Jacksonville, FL 32216
Phone (904) 855-4364
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01620810 | Medicaid | MS | |
| 009932742 | Medicaid | AL |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4183 | AL | MD | Periodontist |
| ME133564 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Family Care, LLC | Past | Accepting new patients | |
| Stepping Stone Center for Recovery, LLC | Past | Accepting new patients | |
| South Mississippi Health Service, Inc | Addiction Medicine | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Substance Abuse Rehabilitation Facility
- Jacksonville, FL
- NPI 1508922931
-
- Family Medicine Physician
- Vestavia Hills, AL
- NPI 1265210645
-
- Psychiatry Physician
- Hattiesburg, MS
- NPI 1447356902
Addiction Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692662400000",
"number": "1700829827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 CORPORATE SQ BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32216",
"telephone_number": "904-855-4364",
"fax_number": "904-661-3757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 CORPORATE SQ BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32216",
"telephone_number": "904-855-4364",
"fax_number": "904-661-3757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OVSON",
"first_name": "ELLEN",
"middle_name": "ANDREWS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-14",
"last_updated": "2023-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RA0401X",
"taxonomy_group": "",
"desc": "Internal Medicine, Addiction Medicine",
"state": "AL",
"license": "4183",
"primary": false
},
{
"code": "2084A0401X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Addiction Medicine",
"state": "MS",
"license": "18338",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME133564",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01620810",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009932742",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.