Ronald K Ellsworth (NPI# 1245556141, PAC ID# 3971778358) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1245556141 |
| PAC ID by PECOS | 3971778358 |
| Professional Enrollment ID | I20130723000595 |
| Full Name | Ronald K Ellsworth |
| Organization Legal Name | CASCADE MEDICAL CENTER HOSPITAL DISTRICT |
| Address |
402 Lake Cascade Pkwy Cascade ID 83611-7702 |
| Phone Number | 2083824285 |
| Gender | M |
| Medical School | UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE |
| Graduation Year | 2010 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 6103739719 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 131308 | CASCADE MEDICAL CENTER |
| 131312 | ST LUKE'S MCCALL |
| 130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
| 130007 | SAINT ALPHONSUS REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 | 2083824285 | CASCADE MEDICAL CENTER HOSPITAL DISTRICT |
| Organization Legal Name | CASCADE MEDICAL CENTER HOSPITAL DISTRICT |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Marc T Nagel | Physician Assistant | Cascade Medical Center Hospital District | 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 |
| James W Dardis | Family Medicine | Cascade Medical Center Hospital District | 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 |
| Chantell Williams | Nurse Practitioner | Cascade Medical Center Hospital District | 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 |
| Jamie Coffey Kelly | Clinical Social Worker | Cascade Medical Center Hospital District | 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 |
| Street Address |
402 LAKE CASCADE PKWY |
| City | CASCADE |
| State | ID |
| Zip | 83611-7702 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer S Anderson | Cardiovascular Disease (cardiology) | Saint Alphonsus Regional Medical Center Inc | 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 |
| Marc T Nagel | Physician Assistant | Cascade Medical Center Hospital District | 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 |
| James W Dardis | Family Medicine | Cascade Medical Center Hospital District | 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 |
| Chantell Williams | Nurse Practitioner | Cascade Medical Center Hospital District | 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 |
| Jamie Coffey Kelly | Clinical Social Worker | Cascade Medical Center Hospital District | 402 Lake Cascade Pkwy, Cascade, ID 83611-7702 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael John Housley | Physician Assistant | Mountain West Derm - Blackhart Pllc | 271 Duffers Ln, Cascade, ID 83611-5506 |
| Chelsea Faust | Physician Assistant | Mountain West Derm - Blackhart Pllc | 271 Duffers Ln, Cascade, ID 83611-5506 |
| Tyler Jordan Mckinnon | Physician Assistant | Mountain West Derm - Blackhart Pllc | 271 Duffers Ln, Cascade, ID 83611-5506 |
| City | CASCADE |
| Zip Code | 83611 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | CASCADE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Ronald K Ellsworth.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.