Individual provider Active NPI

William M Ellis III, D.O.

  • Anesthesiology Physician
  • Alexandria, LA
National Provider Identifier
1336132141
Registry record updated Nov 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
020195 Issued in LA
Practice address
211 4TH St
Alexandria, LA 71301-8421
Phone
(318) 473-3000
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 020195 LA Primary

Addresses

Primary practice location

211 4TH St
Alexandria, LA 71301-8421

Mailing address

211 4TH St
Box 30135
Alexandria, LA 71301-8421
Phone (318) 448-4440

Other practice location 1

10415 Wallace Alley St
Kingsport, TN 37663-3936
Phone (423) 390-0451

Other identifiers 2

IdentifierTypeStateIssuer
1934518MedicaidLA
050022020OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101007000664 LA Practitioner - Anesthesiology 3577755636 Reassigns benefits to 2 organizations
I20250113003238 TN Practitioner - Anesthesiology 3577755636 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Missouri, Kansas City, School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center Anesthesia, IncGroup PAC ID 2769629187, 107 clinicians

Practice addresses (Care Compare)

367 Hospital Blvd
Jackson, TN 38305-2080
Phone (731) 661-2000

620 Skyline Dr
Jackson, TN 38301-3923
Phone (731) 541-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5918TNMDMental Health Counselor
020195LAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Anesthesia Inc. Anesthesiology CurrentSince Oct 12, 2024 Accepting new patients
Lasalle Parish Hospital Service District #1 CurrentSince Jan 16, 2019 Accepting new patients
Paragon Anesthesia PC Anesthesiology CurrentSince Dec 9, 2024 Accepting new patients
Willis Knighton Medical Center Inc. Crna Group Anesthesiology CurrentSince Aug 17, 2020 Accepting new patients
Lasalle Parish Hospital Service District #1 CurrentSince Jan 16, 2019 Accepting new patients
East Tennessee Ambulatory Surgery Center LLC CurrentSince Dec 9, 2024 Accepting new patients
Singing River Health System Past Accepting new patients
Minimally Invasive Image Guided Specialists, LLC Past Accepting new patients
Lasalle Parish Hospital Service District #1 Past Accepting new patients
Melanie C. Firmin, MD Apmc Past Accepting new patients
Radiology Specialty Group LLC PastSince Apr 27, 2025 Accepting new patients
Lasalle Parish Hospital Service Dist No1 Past Accepting new patients
Med-Trans Corporation Past Accepting new patients
Professional Anesthesia Consultants, LLP Anesthesiology Past Accepting new patients

Locations

1049 N Pine Rd
Olla, LA 71465
Phone (318) 495-3175

1102 N Pine Rd
Olla, LA 71465
Phone (318) 495-5302

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

10415 Wallace Alley St
Kingsport, TN 37663
Phone (423) 390-0451

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762300800000",
    "number": "1336132141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 4TH ST",
            "address_2": "BOX 30135",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018421",
            "telephone_number": "318-448-4440",
            "fax_number": "318-473-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 4TH ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713018421",
            "telephone_number": "318-473-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10415 Wallace Alley St",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376633936",
            "country_code": "US",
            "telephone_number": "423-390-0451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "020195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1934518",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "050022020",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.