SKYLER ELLSWORTH NPI 1932784386

NPI Information

NPI: 1932784386
Provider Name: SKYLER ELLSWORTH
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
2840 S MERIDIAN RD
MERIDIAN, ID
ZIP 83642
Phone: (208) 960-0680
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Skyler Ellsworth is a medical physician assistant in Meridian, ID with 3 years of experience. Skyler Ellsworth NPI is 1932784386. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2840 S MERIDIAN RD
MERIDIAN, ID
ZIP 83642-960
Phone: (208) 960-0680
Fax: (208) 960-0678

The NPI 1932784386 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/16/2021 and was last updated on 11/1/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		PA-2207	IDAHO	No
2	390200000X	Student in an Organized Health Care Education/Training Program				No
3	363AM0700X	Physician Assistant	Medical	PA-2207	IDAHO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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