Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jack Ellis I, PA-C

Individual provider Physician Assistant · NPI 1346962982

Jack Ellis I, PA-C is a Physician Assistant in Powell, Ohio. Qualified in 2022, 4 years ago. Practices with Ohiohealth Corporation, a 2,289-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
4
Licensed in
OH
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

4141 N Hampton Dr Ste 200
Powell, OH 43065-7062
Phone: (614) 764-0200
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.007768RX (OH)

Record details

NPI number1346962982
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 12, 2022
Last updated in NPPESNovember 21, 2022
Certification dateNovember 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Ohiohealth Corporation — 2289 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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