Elizabeth Jayde Ison
Physician Assistant in Sandy Hook, KY. Individual provider (NPI-1).
NPI number1154885705
StatusActive
Last updated in NPPESSep 7, 2022
Details
- NPI
- 1154885705
- Entity type
- Individual (NPI-1)
- Name
- Elizabeth Jayde Ison
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jan 29, 2019
- Certification date
- Sep 7, 2022
- Last updated
- Sep 7, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | TC293 | KY | Yes |
Practice location
390 S Ky 7Sandy Hook, KY 41171-6830
Phone 606-738-5155
Mailing address
845 Ky 719Sandy Hook, KY 41171-9065
Phone 606-207-9592
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