Jennifer L Ellegood, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50-002331 Issued in OH

Practice address

5200 Harroun Rd
Sylvania, OH 43560-2168

Phone

(419) 824-1952

Fax

(419) 824-1751

NPI assigned

Jan 24, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

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  • NPI 1558358309
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1780654608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4841 MONROE ST",
            "address_2": "SUITE 103",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234385",
            "telephone_number": "419-471-0493",
            "fax_number": "419-472-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 HARROUN RD",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602168",
            "telephone_number": "419-824-1952",
            "fax_number": "419-824-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLEGOOD",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50-002331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "50-002331",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00354306",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mera El Ramahi
• Rami Saleh El-Assadi
• Elevate Youth Center LLC
• Fuad Elhusain Elnegres, M.D.
• Nailam Elkhechen
• Alex Blair Ellenberger, MD
• Audrey Erlene Ellenwood, PH.D.
• Sandra J Elliot, LPCC
• Elliott & Associates Inc
• Jacob J Elliott, PHD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.