Ryan Scott Ellsworth, DPM

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

8400193-0501 Issued in UT

Practice address

505 Fairburn Rd SW Ste 100
Atlanta, GA 30331-2012

Phone

(404) 618-6077

Fax

(801) 253-6888

NPI assigned

Jul 28, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 9

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in UT, GA, FL3 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 3

Specialty

Podiatry

Education

Other, 2010

Medicare assignment

May accept Medicare assignment

Group practices

Ellsworth Foot and Ankle ClinicGroup PAC ID 2062778160, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd Joseph Jaramillo, DPM

  • Foot & Ankle Surgery Podiatrist
  • Provo, UT
  • NPI 1215315817

  UT

  Medicare reassignment
• Jordan James Radandt

  • Podiatrist
  • Salt Lake City, UT
  • NPI 1053801324

  UT

  Medicare reassignment

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

• Ellsworth Foot and Ankle Clinic

  • Podiatric Clinic/Center
  • Atlanta, GA
  • NPI 1639769672

  GA, Podiatrist

  Medicare reassignment Care Compare group NPD Authorized official
• Ellsworth Foot and Ankle Clinic

  • Foot & Ankle Surgery Podiatrist
  • Riverton, UT
  • NPI 1942549795

  Foot & Ankle Surgery, UT

  Medicare reassignment Care Compare group NPD Authorized official
• Amble Medical

  • Podiatrist
  • Sandy, UT
  • NPI 1134865595
  Medicare reassignment NPD Authorized official
• Ellsworth Foot and Ankle Clinic

  • Podiatrist
  • Salt Lake City, UT
  • NPI 1760151864
  Care Compare group Authorized official
• Ellsworth Foot and Ankle Clinic

  • Podiatrist
  • St George, UT
  • NPI 1922777028
  Care Compare group Authorized official
• Amble Medical

  • Podiatrist
  • Mesquite, NV
  • NPI 1982496253
  NPD Authorized official
• Summit Medical Care

  • Family Medicine Physician
  • Provo, UT
  • NPI 1881216646
  NPD Authorized official

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1104130574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 S 300 W STE 300",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840703654",
            "telephone_number": "801-273-0001",
            "fax_number": "801-253-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 FAIRBURN RD SW STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312012",
            "telephone_number": "404-618-6077",
            "fax_number": "801-253-6888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4019 W 12600 S",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "84096",
            "country_code": "US",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3355 N University Ave Ste 175",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846046620",
            "country_code": "US",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "227 N Westwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Price",
            "state": "UT",
            "postal_code": "845015500",
            "country_code": "US",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2019 E Riverside Dr Ste A101",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847908147",
            "country_code": "US",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3130 S Highland Dr Ste B4",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841063095",
            "country_code": "US",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12780 Race Track Rd Ste 417",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336261395",
            "country_code": "US",
            "telephone_number": "813-535-7707",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "95 White Sage Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Delta",
            "state": "UT",
            "postal_code": "846245555",
            "country_code": "US",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "770 S Highway 99",
            "address_purpose": "LOCATION",
            "city": "Fillmore",
            "state": "UT",
            "postal_code": "846315033",
            "country_code": "US",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12523 S Creek Meadow Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "840657299",
            "country_code": "US",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "RYAN",
        "middle_name": "SCOTT",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-28",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NV",
            "license": "2109",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E5797",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO4406",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001473",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "UT",
            "license": "8400193-0501",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "UT",
            "license": "8400193-0501",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "UT",
            "license": "8400193-0501",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "8400193-0501",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
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            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003111",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UT DPM LICENSE",
            "identifier": "8400193-0501",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "7672880001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA DPM LICENSE",
            "identifier": "E5797",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA DPM LICENSE",
            "identifier": "POD001473",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL DPM LICENSE",
            "identifier": "PO4406",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV DPM LICENSE",
            "identifier": "2109",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eleanor Ellison, MS, RD, LD
• James Alec Ellison Jr.
• Sara Ellison, APC, NCC
• Ellsworth Foot and Ankle Clinic
• Michael Ellsworth, PAA
• Taylor Ellsworth, PA
• Delilah Ellzey, PHD
• Andrew Elmer
• Jillian Elmer
• Caitlyn Sue Elmes, PHARMD

• All providers in Atlanta, GA
• Foot Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.