DR. GREGORY TAYLOR ELLISON JR. (NPI# 1528326667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528326667 |
| Entity Type | Individual |
| Full Name | DR. GREGORY TAYLOR ELLISON JR. |
| Credential | M.D. |
| Practice Address |
4750 Waters Ave Ste 500 Savannah GA 31404 |
| Mailing Address |
4750 Waters Ave Ste 500 Savannah GA 31404-6261 |
| Practice Telephone | 9123548346 |
| Mailing Telephone | 9123548346 |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2018-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
078538 | GA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11706 Mercy Blvd Ste 7, Savannah, GA 314191751 | 9129619753 | 9123555515 |
| 8 Okatie Center Blvd S Ste 201, Bluffton, SC 299097543 | 9123528346 | 9123555515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669567434 | Gregory Lee Ellison | Family Medicine | 2127 E Baseline Rd Ste 104, Tempe, AZ 85283-1537 | 2006-10-04 |
| 1780678516 | Gregory Taylor Ellison | Surgery | 1430 Harper St, Building B, Augusta, GA 30901-0617 | 2005-09-08 |
| Street Address |
4750 WATERS AVE STE 500 |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114924677 | Michael Steven Dahn | Surgery | 4750 Waters Ave Ste 500, Savannah, GA 31404-6261 | 2005-06-30 |
| 1437676590 | Jamie Bridges Goss | Specialist/Technologist, Other | 4750 Waters Ave Ste 500, Savannah, GA 31404-6261 | 2017-08-29 |
| 1992056436 | Yvette N Cruz | Nurse Practitioner | 4750 Waters Ave Ste 500, Savannah, GA 31404-6261 | 2012-09-24 |
| 1871887489 | Ryan O'kelley | Radiology | 4750 Waters Ave Ste 500, Savannah, GA 31404 | 2011-06-01 |
| 1528365723 | Justin B Brown | Surgery | 4750 Waters Ave Ste 500, Savannah, GA 31404 | 2011-02-24 |
| 1043455306 | Davis Sungwhan Moon | Surgery | 4750 Waters Ave Ste 500, Savannah, GA 31404-6261 | 2008-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864580 | Carli A Boatright | Registered Nurse | 4750 Waters Ave Suite 206, Savannah, GA 31404 | 2019-08-01 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| 1336503291 | Miles Love | Student in an Organized Health Care Education/Training Program | 1250 East 66th Street, Savannah, GA 31404 | 2016-04-07 |
| 1134536881 | David Patch | Specialist/Technologist | Pediatric Residency Program, Memorial University, Medical Center 4700 Waters Avenue, Savannah, GA 31404 | 2014-07-15 |
| 1962846683 | Alan Danilo Zevallos | Internal Medicine | 4700 Waters Avenue, University Medical Center, Internal Medicine Residency Program, Memorial Health, Savannah, GA 31404 | 2013-04-24 |
| 1730446394 | Joshua Ryan Fann | Prosthetist | 3840 Waters Ave, Savannah, GA 31404 | 2012-04-19 |
| Find all providers in zip 31404 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285241265 | Jennifer Ann Hales | Surgery | 11090 Mcauley, Suite 100 2a, Savannah, GA 31419 | 2020-09-24 |
| 1023517505 | Antioch Vascular Center, LLC | Surgery | 9104 Middleground Road, Suite 2, Savannah, GA 31406 | 2018-02-09 |
| 1114924677 | Michael Steven Dahn | Surgery | 4750 Waters Ave Ste 500, Savannah, GA 31404-6261 | 2005-06-30 |
| 1528365723 | Justin B Brown | Surgery | 4750 Waters Ave Ste 500, Savannah, GA 31404 | 2011-02-24 |
| 1396076162 | Coastal Vein Solutions LLC | Surgery | 11550 Abercorn St, Savannah, GA 31419-1902 | 2010-01-19 |
| 1043455306 | Davis Sungwhan Moon | Surgery | 4750 Waters Ave Ste 500, Savannah, GA 31404-6261 | 2008-12-15 |
| 1043247232 | Edward J Cohn Jr. | Surgery | 4750 Waters Ave, Suite 500, Savannah, GA 31404 | 2006-06-26 |
| 1306873518 | Anthony M. Sussman | Surgery | 4750 Waters Ave, Suite 500, Savannah, GA 31404-6200 | 2006-06-26 |
| 1407882582 | Christopher L. Wixon | Surgery | 4750 Waters Ave, Suite 500, Savannah, GA 31404-6200 | 2006-06-23 |
| 1790721546 | Christopher E. Walls | Surgery | 4750 Waters Ave, Suite 500, Savannah, GA 31404 | 2006-06-21 |
| Find all providers in SAVANNAH | ||||
Please comment or provide details below to improve the information on DR. GREGORY TAYLOR ELLISON JR..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.