Suzanne Ivie Ellis

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

4005 S Cobb Dr SE
Smyrna, GA 30080-6307

Phone

(770) 431-7055

NPI assigned

May 29, 2024

Last updated

May 29, 2024By the provider in NPPES

Sex

Female

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 GA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Reliant Senior Living LLCGroup PAC ID 0446754451, 117 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Reliant Senior Living LLC

  dba Living Rehab

  • Physical Therapist
  • Alpharetta, GA
  • NPI 1851265755
  Medicare reassignment Care Compare group
• Legacy Healthcare Services, Inc.

  • Physical Therapist
  • Dawsonville, GA
  • NPI 1528419751

  Multi-Specialty

  Medicare reassignment NPD
• Legacy Healthcare Services, Inc.

  • Physical Therapist
  • Winder, GA
  • NPI 1831619337

  Multi-Specialty

  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1194565978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 S COBB DR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806307",
            "telephone_number": "770-431-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "SUZANNE",
        "middle_name": "IVIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Elizee, LPC, LMHC
• Ellen Lewis Consulting Inc
• Amrita Dey Elliott, DPT
• James Sample Elliott Jr., LPC
• Emily Michelle Ellis, AUD
• Theodis Elzie, D.D.S.
• Ikea Emmanuel
• Emory Physical Therapy, LLC
• Emory-Adventist Inc (Emory-Adventist Hospital)
• Reja Syed Emran, MD

• Speech-Language Pathologist in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.