William W Ellis, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

015666 Issued in GA

Practice address

116 Mimosa Dr
Thomasville, GA 31792-6605

Phone

(229) 551-0083

Fax

(229) 227-9642

NPI assigned

May 31, 2005

Last updated

Nov 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: williamellis@ccsg.allscriptsdirect.net

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.

• Hospital Authority of Mitchell County

  dba Archbold Mitchell

  • Critical Access Hospital
  • Camilla, GA
  • NPI 1700830247
  NPD
• Pathology Associates, P.C.

  • Anatomic Pathology Physician
  • Thomasville, GA
  • NPI 1417910043
  NPD
• Archbold Medical Group, Inc.

  • Surgery Physician
  • Thomasville, GA
  • NPI 1831353036
  NPD (past)
• Early Memorial Hospital

  • Critical Access Hospital
  • Blakely, GA
  • NPI 1548214018
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)
• Medical Diagnostics Inc.

  • Radiology Clinic/Center
  • Moultrie, GA
  • NPI 1154372035
  NPD (past)

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1073515300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926605",
            "telephone_number": "229-551-0083",
            "fax_number": "229-227-9642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MIMOSA DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926605",
            "telephone_number": "229-551-0083",
            "fax_number": "229-227-9642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "WILLIAM",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "015666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00264195A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas E Edwards III, MD
• Paul Emanuel Eisele, M.D.
• William Allen Elkins, PHARM D.
• Ellington Eyecare PLLC
• Christopher Ellis, NP-C
• Empower Physical Therapy & Women's Wellness - Thomasville, LLC
• Tina Marie English-Watkins
• ENT Associates of South West Ga
• Nsikan D Essien
• Gabriel Estevez, MD

• Cardiovascular Disease Physician in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.