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ELLIS PEDIATRICS, PLLC
NPI 1134844426
Pediatrics in Jacksonville, FL

Active since October 10, 2022CLIA 10D2275003 · Waiver
12086 FORT CAROLINE RD STE 401, JACKSONVILLE, FL 32225(904) 456-9240 Get Directions Write a Review

NPPES record last updated: March 1, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 1, 2023, Oct 10, 2022 (2 updates tracked since 2022).

About Ellis Pediatrics, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELLIS PEDIATRICS, PLLC (NPI 1134844426) is a healthcare organization registered as a pediatrics in Jacksonville, Florida and active in the NPI registry since October 2022. The organization holds a CLIA Waiver certificate valid through January 12, 2027 and lists Kenyanita Ellis, Owner/pediatrician, as its authorized official.

NPPES Registry Identity

NPI1134844426
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameELLIS PEDIATRICS, PLLC
Location Address12086 FORT CAROLINE RD STE 401Jacksonville, FL 32225-7640
Mailing Address12086 Fort Caroline Rd Ste 401Jacksonville, FL 32225-7640 · (904) 456-9240 · Fax (904) 456-9231
Phone(904) 456-9240
Organization SubpartNo
Authorized OfficialKenyanita EllisOwner/pediatrician · (904) 456-9240
Enumeration DateOctober 10, 2022
Last NPPES UpdateMarch 1, 20232 updates tracked since enumeration
NPPES CertifiedMarch 1, 2023
✔ NPI 1134844426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
12086 FORT CAROLINE RD STE 401, Jacksonville, FL 32225
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter of Alabama.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2275003

Ellis Pediatrics, PLLC · Jacksonville, FL
Active · expires Jan 12, 2027
CLIA Number10D2275003
Laboratory TypePhysician Office
Certificate Effective DateJanuary 13, 2025
Certificate Expiration DateJanuary 12, 2027
Laboratory DirectorKenyanita Ellis
Laboratory Phone(904) 456-9240
Laboratory LocationEllis Pediatrics, PLLC12086 Fort Caroline Rd - Ste 401, Jacksonville, FL 32225
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KENYANITA ELLIS D.O.
Pediatrics
12086 FORT CAROLINE RD STE 401
JACKSONVILLE, FL 32225
Duval County (904) 456-9240

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ellis Pediatrics, PLLC's NPI number?

The NPI number for Ellis Pediatrics, PLLC is 1134844426. It was assigned to this organization in the NPPES registry on October 10, 2022.

Where is Ellis Pediatrics, PLLC located?

Ellis Pediatrics, PLLC is located at 12086 Fort Caroline Rd Ste 401, Jacksonville, FL 32225. The listed phone number is (904) 456-9240.

What is Ellis Pediatrics, PLLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Ellis Pediatrics, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2275003) is associated with this NPI, valid through January 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Ellis Pediatrics, PLLC accept?

Health plans from Ambetter Health and Ambetter of Alabama list Ellis Pediatrics, PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ellis Pediatrics, PLLC was last updated on March 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.