AMY L ELLSWORTH (NPI# 1487908786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487908786 |
| Entity Type | Individual |
| Full Name | AMY L ELLSWORTH |
| Credential | PAC |
| Practice Address |
700 Ironwood Avenue Suite 334 Coeur D'alene ID 83814 |
| Mailing Address |
Po Box 3649 Spokane WA 99220-3649 |
| Practice Telephone | 5098382531 |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2020-10-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA-1022 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1919 Lincoln Way Ste 110, Coeur D Alene, ID 838142527 | 2086254515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518233030 | Amy L. Ellsworth | Dietitian, Registered | 524 12th Street, Huntington Beach, CA 92648-4034 | 2012-03-29 |
| 1629684808 | Amy Lynn Ellsworth | Occupational Therapist | 10 Vo Tech Dr, Oil City, PA 16301-3502 | 2020-09-22 |
| 1922332998 | Amy Ellsworth | Nurse Practitioner | 1751 E Garry Ave, Santa Ana, CA 92705-5814 | 2009-09-24 |
| 1174711436 | Amy Claire Ellsworth | Physician Assistant | 12865 Pointe Del Mar Way, Suite #160, Del Mar, CA 92014-3860 | 2007-10-11 |
| Street Address |
700 IRONWOOD AVENUE SUITE 334 |
| City | COEUR D'ALENE |
| State | ID |
| Zip Code | 83814 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952571184 | Rebecca Lynne Jackson | Physician Assistant | 920 Ironwood Drive, Suite 101, Coeur D'alene, ID 83814-2464 | 2008-03-04 |
| 1194819748 | Richard Andrew Flygare | Physician Assistant | 2288 Merrit Creek Loop, Coeur D'alene, ID 83814 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821695792 | Chelsea Dylan Tennent | Physician Assistant | 1666 E Gentlewind St, Boise, ID 83706-5914 | 2020-10-05 |
| 1922615848 | Allison Cluff | Physician Assistant | 1320 Bennett Ave, Burley, ID 83318-2665 | 2020-09-24 |
| 1245846187 | Adam Baker | Physician Assistant | 271 Jefferson St, Blackfoot, ID 83221-1818 | 2020-09-16 |
| 1265045199 | Julia Claire Brodie | Physician Assistant | 2352 N Apple Ln, Pocatello, ID 83204-7231 | 2020-08-29 |
| 1326651035 | Jenna Marie Castillo | Physician Assistant | 150 Taft Ave, Pocatello, ID 83201-5140 | 2020-08-24 |
| 1174148696 | Colton Jason Randall | Physician Assistant | 3885 Orchard Cir, Ammon, ID 83406-4656 | 2020-06-10 |
| 1871114553 | Samantha Tess Goodrich | Physician Assistant | 721 E Lenz St, Boise, ID 83712-7846 | 2020-05-04 |
| 1174164305 | Tessie Mari Mcinnally | Physician Assistant | 3015 E Magic View Dr # 115, Meridian, ID 83642-3743 | 2019-09-29 |
| 1013562305 | Brianna Suzanne Berg | Physician Assistant | 12535 N Fawn Ct, Hayden, ID 83835-8827 | 2019-08-05 |
| 1003376559 | Kodie Thomas | Physician Assistant | 2086 Picket Ln, Emmett, ID 83617-9104 | 2019-03-21 |
| Find all providers with the same taxonomy | ||||
| City | COEUR D'ALENE |
| Zip Code | 83814 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.