Jonathon Lee Ennis (NPI# 1497267637, PAC ID# 6305106675) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1497267637 |
| PAC ID by PECOS | 6305106675 |
| Professional Enrollment ID | I20180206000197 |
| Full Name | Jonathon Lee Ennis |
| Organization Legal Name | FAMILY WELLCARE CLINIC PLLC |
| Address |
805 Bardstown Rd Suite 12 Springfield KY 40069-1515 |
| Phone Number | 8594817113 |
| Gender | M |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4688940240 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 180024 | SPRING VIEW HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 805 Bardstown Rd, Suite 12, Springfield, KY 40069-1515 | 8594817113 | FAMILY WELLCARE CLINIC PLLC |
| Organization Legal Name | FAMILY WELLCARE CLINIC PLLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Imad A Haddad | Internal Medicine | Family Wellcare Clinic Pllc | 805 Bardstown Rd, Suite 12, Springfield, KY 40069-1515 |
| Bridget Ann Nally | Nurse Practitioner | Family Wellcare Clinic Pllc | 805 Bardstown Rd, Suite 12, Springfield, KY 40069-1515 |
| Street Address |
805 BARDSTOWN RD SUITE 12 |
| City | SPRINGFIELD |
| State | KY |
| Zip | 40069-1515 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Imad A Haddad | Internal Medicine | Family Wellcare Clinic Pllc | 805 Bardstown Rd, Suite 12, Springfield, KY 40069-1515 |
| Bridget Ann Nally | Nurse Practitioner | Family Wellcare Clinic Pllc | 805 Bardstown Rd, Suite 12, Springfield, KY 40069-1515 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Julia Keeling Brown | Internal Medicine | 219 W Main St, Springfield, KY 40069-1228 | |
| Brian Wells | Family Practice | Homebound Physician Services Pllc | 101 W Grundy Ave, Springfield, KY 40069-1411 |
| John W Cecconi Jr. | Optometry | Central Kentucky Optometric Associates Psc | 108 Commercial Ave, Springfield, KY 40069-1413 |
| Audrey R Hunt | Nurse Practitioner | Spring View Hospital LLC | 79 Bobolink Dr, Springfield, KY 40069-1516 |
| Stefanie Kaye Spalding | Nurse Practitioner | Spring View Hospital LLC | 79 Bobolink Dr, Springfield, KY 40069-1516 |
| Stephanie Settles Harmon | Nurse Practitioner | Spring View Hospital LLC | 79 Bobolink Dr, Springfield, KY 40069-1516 |
| Mandy Vittitow | Nurse Practitioner | Spring View Hospital LLC | 79 Bobolink Dr, Springfield, KY 40069-1516 |
| James E Escaloni | Physical Therapy | Elizabethtown Physical Therapy Psc | 49 Bonnie Blvd, Suite 2, Springfield, KY 40069-1517 |
| Jason D Myers | Physical Therapy | Elizabethtown Physical Therapy Psc | 49 Bonnie Blvd, Suite 2, Springfield, KY 40069-1517 |
| Nathan R Ladd | Physical Therapy | Elizabethtown Physical Therapy Psc | 49 Bonnie Blvd, Suite 2, Springfield, KY 40069-1517 |
| Find all physicians in zip 40069 | |||
| City | SPRINGFIELD |
| Zip Code | 40069 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | SPRINGFIELD + PHYSICIAN ASSISTANT |
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| 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.