NPIMap

Individual provider Active NPI

Zachary Dimitri Ellis, DO

  • Internal Medicine Physician
  • Tupelo, MS
National Provider Identifier
1124778873
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33630 Issued in MS
Practice address
830 S Gloster St
Tupelo, MS 38801-4996
Phone
(662) 377-2539
Fax
(662) 377-2920
NPI assigned
Mar 25, 2022
Sex
Male
Sole proprietor
Yes

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 4

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

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
William Carey University College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Hospitalists of Ms, LLC 37 clinicians
Mississippi LTAC Holdings, LLC 8 clinicians
North Mississippi Medical Center, Inc. 361 clinicians

Practice addresses (Care Compare)

1100 Belk Blvd
Oxford, MS 38655-5242
Phone (662) 232-8100

303 Medical Ctr Dr
Suite B
Batesville, MS 38606-8608
Phone (662) 703-4167

830 S Gloster St
Tupelo, MS 38801-4934
Phone (662) 377-3000

Hospital & facility affiliations

  • North Mississippi Medical Center Hospital, Tupelo, MS, CCN 250004
  • Baptist Memorial Hospital North Ms Hospital, Oxford, MS, CCN 250034
  • Pontotoc Health Service Inc Cah Hospital, Pontotoc, MS, CCN 251308
  • North Mississippi Specialty Hospital Long-term care hospital, Batesville, MS, CCN 252014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241209001845 MS Practitioner - Internal Medicine 7618358789 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33630MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Current Accepting new patients
North Mississippi Medical Center Inc. CurrentSince Jul 1, 2025 Accepting new patients
North Mississippi Medical Center Inc Current Accepting new patients
Mississippi LTAC Holdings, LLC CurrentSince Nov 7, 2024 Accepting new patients
Comprehensive Hospitalists of Ms, LLC Current Accepting new patients
Comprehensive Hospitalists of Ms, LLC CurrentSince Oct 1, 2025 Accepting new patients
Comprehensive Hospitalists of Ms, LLC Internal Medicine CurrentSince Oct 1, 2025 Accepting new patients
North Mississippi Medcial Center, Inc. CurrentSince Jul 1, 2025 Accepting new patients
North Mississippi Medical Center, Inc. Past Accepting new patients
Sunrise Medical Group PLLC PastSince Nov 7, 2024 Accepting new patients

Locations

101 La Rue France
Ste 500
Lafayette, LA 70508
Phone (337) 269-9566

1105 Earl Frye Blvd
Amory, MS 38821
Phone (662) 256-7111

303 Medical Center Dr
Ste B
Batesville, MS 38606
Phone (662) 703-4167

1100 Belk Blvd
Oxford, MS 38655
Phone (662) 636-1000

808 Varsity Dr
Tupelo, MS 38801
Phone (662) 377-2386

830 S Gloster St
Tupelo, MS 38801
Phone (662) 377-3136

Interoperability endpoints

  • Direct secure messaging: zellis473217@direct.bmhcc.org
  • Direct secure messaging: zacharyellis@nmhs.medalliesdirect.net

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33630 MS Primary

Addresses

Primary practice location

830 S Gloster St
Tupelo, MS 38801-4996

Mailing address

808 Varsity Dr
Tupelo, MS 38801-4613
Phone (662) 377-3204

NPI Registry JSON

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751846400000",
    "number": "1124778873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 VARSITY DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014613",
            "telephone_number": "662-377-3204",
            "fax_number": "662-377-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014996",
            "telephone_number": "662-377-2539",
            "fax_number": "662-377-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ZACHARY",
        "middle_name": "DIMITRI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-25",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "33630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.