Adam Wesley Ellis, M.D

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

40994 Issued in KY

Practice address

1623 Nashville St
Ste 106
Russellville, KY 42276-8889

Phone

(270) 726-8090

Fax

(270) 726-9008

NPI assigned

Sep 2, 2006

Last updated

Aug 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, KY2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

Icahn School of Medicine at Mount Sinai, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Dekalb Community Hospital Hospital, Smithville, TN, CCN 440148

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adam.ellis.1@7654.direct.athenahealth.com
• Direct secure messaging: fhi9900@yourcarecommunity.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Saint Thomas Medical Partners

  dba Ascension Medical Group Saint Thomas

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1437194669
  Medicare reassignment Care Compare group NPD
• Apogee Medical Group Kentucky PSC

  • General Practice Physician
  • Corbin, KY
  • NPI 1356503114
  Medicare reassignment NPD
• Logan Physician Practice, LLC

  dba Auburn Community Family Clinic

  • Nurse Practitioner
  • Auburn, KY
  • NPI 1265740765
  Medicare reassignment NPD
• Adam Ellis, MD, PLLC

  • Surgery Physician
  • Russellville, KY
  • NPI 1033216270
  Authorized official Same address or phone
• Logan Physician Practice LLC

  dba Logan Primary Care - Russellville

  • Internal Medicine Physician
  • Russellville, KY
  • NPI 1013408053
  NPD
• Logan Physician Practice LLC

  • Family Medicine Physician
  • Russellville, KY
  • NPI 1649203043

  Surgery

  NPD
• Saint Thomas Medical Partners

  dba Baptist Sports Medicine

  • Clinical Neuropsychologist
  • Nashville, TN
  • NPI 1558506980
  NPD
• Beaufort County Memorial Hospital

  • General Practice Physician
  • Beaufort, SC
  • NPI 1336180165
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Thomas Dekalb Hospital, LLC

  dba Ascension Saint Thomas Dekalb

  • General Acute Care Hospital
  • Smithville, TN
  • NPI 1649659582
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1003918731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 NASHVILLE ST",
            "address_2": "STE 106",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422768889",
            "telephone_number": "270-726-8090",
            "fax_number": "270-726-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 NASHVILLE ST",
            "address_2": "STE 106",
            "city": "RUSSELLVILLE",
            "state": "KY",
            "postal_code": "422768889",
            "telephone_number": "270-726-8090",
            "fax_number": "270-726-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ADAM",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "40994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• David R. Whitley (Whitley's Pharmacy)
• Erin Deans
• James Carlisle Dodson, MD
• Ronald B Elder, M.D., PSC
• Daniel Lee Emery, PHARM.D.
• Jessica L Estes, DNP, APRN
• Family Health Care Associates 14
• Fast Pace Kentucky, PLLC
• First Steps Wellness LLC

• Surgery Physician in Russellville, KY
• Providers in Russellville, KY by specialty
• Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.