Natasha Ellis, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

406146 Issued in NY

Practice address

702 Canton Rd NE
Marietta, GA 30060-7271

Phone

(770) 428-4486

NPI assigned

May 13, 2016

Last updated

Aug 25, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Orenda Psychiatry PLLC

  dba Orenda Psychiatry

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
  • NPI 1528663945
  Medicare reassignment NPD
• Kennestone Hospital, Inc

  dba Wellstar Kennestone Hospital Inpatient Psych Unit

  • Psychiatric Hospital Unit
  • Atlanta, GA
  • NPI 1689361438
  NPD (past)
• The Philip Israel Breast Center, P.C.

  • Surgery Physician
  • Marietta, GA
  • NPI 1942310917
  NPD (past)

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1083060578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 CANTON RD NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607271",
            "telephone_number": "770-428-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 CANTON RD NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300607271",
            "telephone_number": "770-428-4486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 5th Ave Ste 903-10",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100118002",
            "country_code": "US",
            "telephone_number": "347-707-7735",
            "fax_number": "347-745-0992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "NATASHA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-13",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN189933",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Thomas Ellis, NP-BC, MSSM
• Kelly Abbott Ellis, DPT
• Kirk Richard Ellis, PSYD
• Melissa Ellis, MSW
• Mia Moenae Ellis
• Mark Ellison, LAMFT
• Tina Anderson Ellsworth, M.S. ED CCC-SLP
• Elmer Anthony Musarra II
• Kevin John Elmore, MA, LPC
• Elpida Psychiatry

• Psychiatric/Mental Health Nurse Practitioner in Marietta, GA
• Providers in Marietta, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; 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.