Kimberly Lynn Ellis, CPNP-AC

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

APRN-NP315883 Issued in GA

Practice address

2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117

Phone

(404) 785-5437

NPI assigned

Apr 9, 2026

Last updated

Apr 9, 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1775692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1326981960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 MEMORIAL DR SE UNIT 1421",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303161789",
            "telephone_number": "914-500-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 N DRUID HILLS RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303293117",
            "telephone_number": "404-785-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Johnson Fy Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421605",
            "country_code": "US",
            "telephone_number": "404-785-5437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "GA",
            "license": "APRN-NP315883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janine Ellis
• Joeann Renee' Ellis, PT
• Kelly S Ellis, ATC, LAT, PTA
• Kelvin Ellis Sr.
• Kenna Healy Ellis, MD
• Latrese Ann Ellis, NP
• Linda Ellis
• Lucia Ellis, LCSW
• Mesha Lygia Ellis, PH.D.
• Porshay Ellis

• Pediatric Surgery Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.