Elisa Nicole Lang, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.003575RX Issued in OH

Practice address

835 W Emmitt Ave
Waverly, OH 45690-1190

Phone

(740) 947-7662

Fax

(740) 941-0099

NPI assigned

Sep 12, 2012

Last updated

Nov 14, 2023By the provider in NPPES

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 names 1

• Ms. Elisa Nicole Gullion Former name

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Somc Medical Care Foundation, Inc.Group PAC ID 9436061645, 388 clinicians

Genesis Medical Group, LLCGroup PAC ID 7719040385, 265 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southern Ohio Medical Center Hospital, Portsmouth, OH, CCN 360008
• Genesis Hospital Hospital, Zanesville, OH, CCN 360039

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elisa.gullion@somc.medicity.net

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.

• Genesis Medical Group LLC

  • General Practice Physician
  • Zanesville, OH
  • NPI 1063663433
  Medicare reassignment Care Compare group NPD
• Somc Medical Care Foundation, Inc.

  • Family Medicine Physician
  • Portsmouth, OH
  • NPI 1457467227

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Genesis Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Coshocton, OH
  • NPI 1144022187
  NPD
• Somc Medical Care Foundation, Inc.

  dba Somc Radiology Associates

  • Diagnostic Radiology Physician
  • Portsmouth, OH
  • NPI 1366686230
  NPD
• George E. Esham, M.D. Inc.

  • Internal Medicine Physician
  • Portsmouth, OH
  • NPI 1730264094
  NPD (past)
• Yong D Song MD Inc

  • Obstetrics & Gynecology Physician
  • Portsmouth, OH
  • NPI 1154475135
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Genesis Healthcare System

  • Community/Retail Pharmacy
  • Zanesville, OH
  • NPI 1184435414

  Hospital

  Care Compare affiliation
• Genesis Healthcare System

  dba Genesis Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Zanesville, OH
  • NPI 1477150951

  Hospital

  Care Compare affiliation
• Genesis Healthcare System

  • General Acute Care Hospital
  • Zanesville, OH
  • NPI 1598868655
  Care Compare affiliation
• Genesis Healthcare System

  dba Genesis Outpatient Pharmacy 1C

  • Community/Retail Pharmacy
  • Coshocton, OH
  • NPI 1710839436

  Hospital

  Care Compare affiliation
• Southern Ohio Medical Center

  • General Acute Care Hospital
  • Portsmouth, OH
  • NPI 1053342816
  Care Compare affiliation

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

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1750631156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 27TH ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456622677",
            "telephone_number": "740-356-8681",
            "fax_number": "740-353-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 W EMMITT AVE",
            "city": "WAVERLY",
            "state": "OH",
            "postal_code": "456901190",
            "telephone_number": "740-947-7662",
            "fax_number": "740-941-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "ELISA",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-12",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003575RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elisa.lang@somc.medicity.net",
            "affiliation": "N",
            "address_1": "835 W Emmitt Ave",
            "city": "Waverly",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456901190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ELISA",
            "last_name": "GULLION",
            "middle_name": "NICOLE",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carol Knisley
• Janice A Kubiak, CDCA
• Andrew Dennis Kummer, CDCA
• Thomas James Kyle, LCDCII
• Heather M Landman
• Michael Lanning
• Ashley Lansing
• Todd Laplante
• David William Laverick Jr., CDCA
• Kori Olivia Rayann Lavey

• Physician Assistant in Waverly, OH
• Providers in Waverly, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.