MARK A ELLIS (NPI# 1730150194) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730150194 |
| Entity Type | Individual |
| Full Name | MARK A ELLIS |
| Credential | MD |
| Practice Address |
1765 Old West Broad St Bldg 1 Ste 200 Athens GA 30606-2867 |
| Mailing Address |
Po Box 7577 Athens GA 30604-7577 |
| Practice Telephone | 7062080451 |
| Practice Fax Number | 7062080147 |
| Mailing Telephone | 7062080451 |
| Mailing Fax Number | 7062080147 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2012-08-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
036525 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000526479B | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972897080 | Mark Ellis | Podiatrist | 12592 S 150 E, Draper, UT 84020-8611 | 2011-06-06 |
| 1659682219 | Mark Kenneth Ellis | Emergency Medicine | 2 5th Ave Apt 2d, New York, NY 10011-8832 | 2010-06-29 |
| 1174661672 | Mark Joseph Ellis | Chiropractor | 41 Western Avenue, Rochester, NH 03867 | 2007-02-05 |
| 1336204171 | Mark J Ellis | Respiratory Therapist, Certified | 1101 Jefferson Blvd, Hagerstown, MD 21742-5037 | 2006-12-22 |
| 1184719262 | Mark Allen Ellis | Dentist | 910 Averitt Rd, Greenwood, IN 46143-9540 | 2006-10-04 |
| 1437240124 | Mark Owen Ellis | Podiatrist | 582 22nd Street, Astoria, OR 97103 | 2006-09-27 |
| 1083632244 | Mark Brian Ellis | Family Medicine | 1018 Rucker Blvd, Ste A, Enterprise, AL 36330-3675 | 2006-07-17 |
| 1265426894 | Mark Alan Ellis | Dentist | 951 Riverfront Pkwy, Suite 302, Chattanooga, TN 37402-2185 | 2005-09-09 |
| 1316580509 | Mark Duane Ellis | Licensed Practical Nurse | 2600 Se Belmont St, Portland, OR 97214-2916 | 2019-10-21 |
| 1629427752 | Mark Andrew Ellis | Otolaryngology | 169 Ashley Ave, Room 202 Main Hospital, Msc 333, Charleston, SC 29425-9080 | 2016-06-09 |
| Street Address |
1765 OLD WEST BROAD ST BLDG 1 STE 200 |
| City | ATHENS |
| State | GA |
| Zip Code | 30606-2867 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518948835 | Ormonde M Mahoney | Orthopaedic Surgery | 1765 Old West Broad St, Athens, GA 30606-2853 | 2005-11-14 |
| 1245858448 | Adam Schreiber | Physical Therapy Assistant | 1765 Old West Broad St, Athens, GA 30606-2853 | 2020-07-14 |
| 1164053229 | Quinavere Jarrells | Specialist/Technologist, Other | 1765 Old West Broad St, Athens, GA 30606-2853 | 2020-01-28 |
| 1558915884 | Kelli Whitfield Garrett | Specialist/Technologist, Other | 1765 Old West Broad St, Athens, GA 30606-2853 | 2019-07-25 |
| 1427517523 | Kayla Michele Gittens | Occupational Therapist | 1765 Old West Broad St, Athens, GA 30606-2853 | 2019-03-18 |
| 1568942738 | Brandon Scott Vlahos | Physician Assistant | 1765 Old West Broad St, Athens, GA 30606-2887 | 2018-08-17 |
| 1114404589 | Clayton O Carroll | Physical Therapist | 1765 Old West Broad St, Athens, GA 30606-2853 | 2018-07-27 |
| 1376039578 | Micah Lee Sales | Physical Therapist | 1765 Old West Broad St, Athens, GA 30606-2853 | 2018-07-11 |
| 1508356130 | Paul Michael Lally | Physical Therapist | 1765 Old West Broad St, Athens, GA 30606-2853 | 2018-05-18 |
| 1316450216 | Caroline B Batson | Specialist/Technologist, Other | 1765 Old West Broad St, Athens, GA 30606-2853 | 2017-11-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816962 | Kofi Darkwa Seffah | Student in an Organized Health Care Education/Training Program | 1199 Prince Ave #70, 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-09-16 |
| 1831712363 | Rebecca John | Licensed Practical Nurse | 240 Mitchel Bridge Road, Athens, GA 30606 | 2020-05-19 |
| 1497375612 | Alfred Ka-shing Wong | Student in an Organized Health Care Education/Training Program | 1270 Prince Ave Suite 201, Athens, GA 30606 | 2020-04-17 |
| 1881223956 | Lauren Fesperman | Nurse Practitioner | 242 King Ave Ste 130, Athens, GA 30606 | 2020-04-02 |
| 1255966081 | Westminster Presbyterian Homes, Inc. | Skilled Nursing Facility | 1400 Live Oak Ln, Building 100, Athens, GA 30606 | 2020-03-12 |
| 1255981700 | Carol Cameron Cready-pyle | Social Worker | 1551 Jennings Mill Pkwy Ste 1700, Athens, GA 30606 | 2019-09-17 |
| 1013576016 | Lauren Gruendling | Nurse Practitioner | 242 King Avenue, Suite 210, Athens, GA 30606 | 2019-06-12 |
| 1760045223 | Dominic Ofosu Amakye | Student in an Organized Health Care Education/Training Program | 1270 Prince Avenue Suite 201, Athens, GA 30606 | 2019-04-19 |
| 1740740422 | Juan G Salazar Castillo | Student in an Organized Health Care Education/Training Program | Community Internal Medicine of Athens, 1500 Oglethorpe Ave Suite 200d, Athens, GA 30606 | 2019-03-20 |
| 1750869020 | Jennifer Emily Chapman | Physical Therapist | 1021 Parkway Blvd Ste 101, Athens, GA 30606 | 2018-07-30 |
| Find all providers in zip 30606 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548241615 | Reginald Strother | Pain Medicine | 1620 Prince Ave, Athens, GA 30606-6008 | 2005-11-07 |
| 1689178170 | Ashford Pain Solutions, LLC | Pain Medicine | 1000 Hawthorne Ave Ste J, Athens, GA 30606-2168 | 2018-03-20 |
| 1609021260 | Athens Regional Health Center LLC | Pain Medicine | 1010 Prince Ave, #184n, Athens, GA 30606-5805 | 2008-11-24 |
| 1871768671 | Daniel Stephen Thomas | Pain Medicine | 830 King Ave, Athens, GA 30606-2889 | 2008-04-23 |
| 1104900497 | Northeast Georgia Anesthesia Services Inc. | Pain Medicine | 1620 Prince Ave, Athens, GA 30606-6008 | 2006-10-24 |
| 1932180759 | Richard D Campbell | Pain Medicine | 1620 Prince Ave, Athens, GA 30606-6008 | 2005-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891302998 | Apollo Spine and Pain Center | Pain Medicine | 4415 Front Nine Dr, Cumming, GA 30041-6063 | 2020-09-23 |
| 1235756792 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 2100 Central Ave Ste 6, Augusta, GA 30904-6709 | 2020-07-01 |
| 1902433147 | Sun Pain Institute LLC | Pain Medicine | 836 E 65th St Ste 38, Savannah, GA 31405-4495 | 2020-03-26 |
| 1679107338 | Atlanta Interventional Pain Management, LLC | Pain Medicine | 13190 Highway 92 Ste 120, Woodstock, GA 30188-4406 | 2020-03-02 |
| 1578193355 | Regenerative Spine and Pain Specialists | Pain Medicine | 874 Lanier Ave W Ste 250, Fayetteville, GA 30214-7662 | 2020-01-22 |
| 1437790839 | Specialty Spine and Pain, PC | Pain Medicine | 1498 Jesse Jewell Pkwy Se Ste D, Gainesville, GA 30501-3874 | 2019-10-07 |
| 1154962165 | Specialty Spine and Pain, PC | Pain Medicine | 2695 Old Winder Hwy Ste 150, Braselton, GA 30517-6076 | 2019-10-01 |
| 1659912665 | Specialty Spine and Pain, PC | Pain Medicine | 5005a Lanier Islands Pkwy Ste 100, Buford, GA 30518-1802 | 2019-10-01 |
| 1114578515 | Interventional Spine and Pain Management Center, PC | Pain Medicine | 6002 Highway 53 E Ste 110, Dawsonville, GA 30534-6227 | 2019-09-26 |
| 1477106771 | Spine Center of Southeast Georgia LLC | Pain Medicine | 52a Lindsey Lane, Kingsland, GA 31548-6855 | 2019-07-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MARK A ELLIS.
| 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.