RICHARD S ELLIN


Address: 455 Philip Boulevard, Suite 130, Kaiser Permanente Lawrenceville Medical Office, Lawrenceville, GA 30046
Phone: 6789855000

RICHARD S ELLIN (NPI# 1871506386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1871506386
Entity Type Individual
Full Name RICHARD S ELLIN
Credential MD
Practice Address 455 Philip Boulevard, Suite 130
Kaiser Permanente Lawrenceville Medical Office
Lawrenceville
GA 30046
Mailing Address 3495 Piedmont Road, Ne
Nine Piedmont Center
Atlanta
GA 30305
Practice Telephone 6789855000
Practice Fax Number 8285262914
Mailing Telephone 4045045678
Mailing Fax Number 8285261285
Enumeration Date 2006-08-14
Last Update Date 2018-07-25
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine 2016-01385 NC Allopathic & Osteopathic Physicians
Y 207R00000X Internal Medicine 025604 GA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NC MEDICARE PTAN NCT328A194 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
209 Hospital Dr Ste 104, Highlands, NC 287417622 8285264346

Office Location

Street Address 455 PHILIP BOULEVARD, SUITE 130
KAISER PERMANENTE LAWRENCEVILLE MEDICAL OFFICE
City LAWRENCEVILLE
State GA
Zip Code 30046

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NPI Name Taxonomy Address Enumeration
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1679060388 Christopher Puckett Student in an Organized Health Care Education/Training Program 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 2018-04-18
1457851255 Advanced Urology Institute of Georgia Urology 501 Crown Point Way, Lawrenceville, GA 30046 2018-02-19
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Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1902420573 Brenda Willis-wade Internal Medicine 1600 Keswick Place Dr, Lawrenceville, GA 30043-6627 2020-05-30
1780123588 Feliks Shtindler Md PC Internal Medicine 3450 Princeton Pike, Suite 120, Lawrenceville, NJ 08648 2017-02-14
1902200835 Odianosen I Obadan Internal Medicine 601 Professional Dr Ste 235a, Lawrenceville, GA 30046-7697 2014-10-21
1831416270 Nidhip Anil Patel Internal Medicine 500 Medical Center Blvd Ste 310, Lawrenceville, GA 30046-3332 2010-04-26
1700108784 North Atlanta Medical Clinic, L.l.c Internal Medicine 3664 Club Drive, Suite 201, Lawrenceville, GA 30044 2010-02-18
1932355294 New Horizons Internal Medicine LLC Internal Medicine 771 Old Norcross Rd Ste 110, Lawrenceville, GA 30045-4317 2008-08-18
1376704106 Samuel Deutsch Md PC Internal Medicine 316 W Pike St Ste 100, Lawrenceville, GA 30045-4878 2008-06-24
1033385877 Neel Jitendra Gandhi Internal Medicine 2997 Princeton Pike, #201, Lawrenceville, NJ 08648 2008-05-01
1184899510 Edward Joseph Ostrowski Internal Medicine 276 Fieldboro Dr, Lawrenceville, NJ 08648-3914 2008-04-27
1376717504 Victorine Mafoueka Nguena Internal Medicine 3664 Club Dr Ste 201, Lawrenceville, GA 30044-2959 2008-04-18
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Competitor

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City LAWRENCEVILLE
Zip Code 30046

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Dataset Information

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.

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