Individual provider Active NPI

Emilee Q. Carlton, PA-C

  • Physician Assistant
  • Columbus, OH
National Provider Identifier
1770061236
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005702RX Issued in OH
Practice address
452 W 10TH Ave
Columbus, OH 43210-1240
Phone
(614) 293-5502
Fax
(614) 293-4726
NPI assigned
Aug 6, 2018
Last updated
Apr 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.005702RX OH Primary

Addresses

Primary practice location

452 W 10TH Ave
Columbus, OH 43210-1240

Mailing address

700 Ackerman Rd Ste 570
Columbus, OH 43202-1579
Phone (614) 366-8030

Other practice location 1

1 Wyoming St
Dayton, OH 45409-2722
Phone (937) 223-4461

Other identifiers 1

IdentifierTypeStateIssuer
0322548MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181128002721 OH Practitioner - Physician Assistant 4284978487 Reassigns benefits to 1 organization
I20241226003182 DC Practitioner - Physician Assistant 4284978487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inova Health Care ServicesGroup PAC ID 2466351093, 1,821 clinicians

Practice addresses (Care Compare)

3300 Gallows Rd
Falls Church, VA 22042-3307
Phone (703) 776-4001

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc Physician Assistant CurrentSince May 9, 2022 Accepting new patients
Inova Health Care Services CurrentSince Jan 6, 2025 Accepting new patients
Premier Health Specialists Inc CurrentSince May 9, 2022 Accepting new patients
Inova Health Care Services CurrentSince Jan 6, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1770061236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 570",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021579",
            "telephone_number": "614-366-8030",
            "fax_number": "614-366-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-5502",
            "fax_number": "614-293-4726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wyoming St",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092722",
            "country_code": "US",
            "telephone_number": "937-223-4461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLTON",
        "first_name": "EMILEE",
        "middle_name": "Q.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-06",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005702RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0322548",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.