DR. DAVID JASON ELLENBOGEN (NPI# 1831222090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1831222090 |
Entity Type | Individual |
Full Name | DR. DAVID JASON ELLENBOGEN |
Credential | DPM |
Practice Address |
2826 Randolph Rd Charlotte NC 28211-1386 |
Mailing Address |
Po Box 60447 Charlotte NC 28260-0447 |
Practice Telephone | 7043580308 |
Practice Fax Number | 7043580039 |
Enumeration Date | 2007-03-14 |
Last Update Date | 2020-10-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
615 | NC | Podiatric Medicine & Surgery Service Providers |
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
615 | NC | Podiatric Medicine & Surgery Service Providers |
N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
615 | NC | Podiatric Medicine & Surgery Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942351176 | David Michael Ellenbogen | Chiropractor | 504 W Osage St, Pacific, MO 63069-1335 | 2007-01-15 |
1417570516 | David Ellenbogen | Student in an Organized Health Care Education/Training Program | 675 Hoes Ln W, Piscataway, NJ 08854-8021 | 2020-05-22 |
Street Address |
2826 RANDOLPH RD |
City | CHARLOTTE |
State | NC |
Zip Code | 28211-1386 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588660716 | Glenn Bradford Perry | Orthopaedic Surgery | 2826 Randolph Rd, Charlotte, NC 28211-1019 | 2005-06-22 |
1942858733 | Jonathan Oakes | Physician Assistant | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2019-08-27 |
1083127419 | Jodi Ann Arreguin | Physician Assistant | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2017-11-07 |
1659819126 | Lauren Scollin | Physical Therapist | 2826 Randolph Rd, 2nd Floor, Charlotte, NC 28211-1386 | 2017-02-06 |
1538601695 | Chelsea Parker | Physical Therapist | 2826 Randolph Rd, 2nd Floor, Charlotte, NC 28211-1386 | 2016-11-07 |
1437605169 | Select Physical Therapy | Clinic/Center | 2826 Randolph Rd, 2nd Floor, Charlotte, NC 28211 | 2016-09-01 |
1861945156 | Justin R.n. Kocan | Physical Therapist | 2826 Randolph Rd, 2nd Floor, Charlotte, NC 28211-1386 | 2016-08-03 |
1265771505 | Kristine Ann Pumpa | Physical Therapist | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2013-02-06 |
1043581754 | Jeffrey Bennett | Specialist/Technologist | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2012-01-26 |
1306116421 | John Ryan Maynard | Physician Assistant | 2826 Randolph Rd, Charlotte, NC 28211-1386 | 2012-01-05 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184277832 | I and J Wheelchair Transportation | Non-emergency Medical Transport (VAN) | 1512 Delane Avenue, Charlotte, NC 28211 | 2019-07-22 |
1922563923 | The Charlotte-mecklenburg Hospital Authority | Psychiatry & Neurology | 447 Billingsley Rd, Cottage A, Charlotte, NC 28211 | 2019-02-04 |
1649798273 | Ally Home Care Charlotte LLC | In Home Supportive Care | 3711 Latrobe Drive Suite 520, Charlotte, NC 28211 | 2017-09-04 |
1154866770 | Vaibhav Bajaj | Dentist | 2809 Coltsgate Rd Ste 200, Charlotte, NC 28211 | 2017-01-05 |
1508254939 | Lindsay Marie Smits | Speech-Language Pathologist | 427 N. Wendover Rd., Charlotte, NC 28211 | 2015-01-08 |
1457755480 | Kristen Hammer | Physical Therapy Assistant | 4120 Providence Rd Apt D, Charlotte, NC 28211 | 2014-10-20 |
1669805610 | Carla Elizabeth Scott | Physical Therapist | 3500 Ellington Street, Dr. Carlton Watkins Center, Charlotte, NC 28211 | 2013-08-14 |
1760726368 | Jill Hensdale Shipp | Social Worker | 307 Hunter Lane, Charlotte, NC 28211 | 2012-11-20 |
1346592722 | Danielle Marie Benoit | Occupational Therapist | 3541 Randolph Road Suite 100 W, Charlotte, NC 28211 | 2012-10-09 |
1487910832 | John Joseph Marcel Jr. | Orthopaedic Surgery | 449 North Wendover Rd Ste A, Charlotte, NC 28211 | 2012-04-10 |
Find all providers in zip 28211 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497376370 | Carolina Foot & Ankle of Huntersville, PC | Podiatrist | 10310 Couloak Dr Ste 200, Charlotte, NC 28216-7673 | 2020-05-01 |
1710381777 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 9216 Ardrey Kell Rd Ste 100, Charlotte, NC 28277-4954 | 2014-10-20 |
1134463060 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 2607 East Seventh St., Suite 100, Charlotte, NC 28204-4308 | 2012-11-15 |
1396099511 | Instride Foot and Ankle Specialists, Pllc | Podiatrist | 12610 N Community House Rd Ste 202, Charlotte, NC 28277-3838 | 2012-11-09 |
1891046454 | Matthew Borns | Podiatrist | 6831 Fairview Rd, Charlotte, NC 28210-3386 | 2012-09-23 |
1821251737 | Michael J. Ryan, Dpm, Pa | Podiatrist | 8912 Blakeney Profession Center, A2, Charlotte, NC 28277 | 2008-07-10 |
1770631384 | Michael J Ryan Dpm Pa | Podiatrist | 8310 Medical Plaza Dr Ste E, Charlotte, NC 28262-6703 | 2007-01-08 |
1275693509 | Mark Miceli | Podiatrist | 8301 University Exec Park Dr Ste 112, Charlotte, NC 28262-3593 | 2006-12-08 |
1174606156 | John Josph Longobardo | Podiatrist | 9124 S Tryon St, Suite J, Charlotte, NC 28273-3114 | 2006-10-23 |
1871524595 | Charlotte Foot Clinic | Podiatrist | 4016 Wilkinson Blvd, Ste A, Charlotte, NC 28208 | 2006-07-05 |
Find all providers in CHARLOTTE |
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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.