Justin Thomas Ellis, NP-BC, MSSM

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2024093910 Issued in GA

Practice address

1809 Canton Rd
Marietta, GA 30066-6343

Phone

(678) 335-4865

NPI assigned

Jan 8, 2025

Last updated

Oct 13, 2025By the provider in NPPES

Sex

Male

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

Enrolled in GA

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.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Piedmont Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1114317062
  Medicare reassignment

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1336959865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 SANDY POINTE",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 CANTON RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666343",
            "telephone_number": "678-335-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JUSTIN",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "NP-BC, MSSM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "2024093910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie Allene Nichole Elliott, LPC, LMFT, NCC, CST
• Sarah Bentley Elliott, PA-C
• Bernice Ellis-Veal, LPN
• Erin Lynn Ellis, DENTAL ASSISTANT
• Janie Ellis
• Kelly Abbott Ellis, DPT
• Kirk Richard Ellis, PSYD
• Melissa Ellis, MSW
• Mia Moenae Ellis
• Natasha Ellis, NP

• Family Nurse Practitioner in Marietta, GA
• Providers in Marietta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2025; 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.