Randall E Ellis, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD27444 Issued in TN

Practice address

2320 Wilma Rudolph Blvd
Clarksville, TN 37040-5821

Phone

(931) 645-1564

Fax

(931) 645-3842

NPI assigned

Jun 6, 2006

Last updated

Jul 13, 2026By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN, KY, TX3 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 3

Specialty

Emergency Medicine

Education

Vanderbilt University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Carlos Apache Healthcare CorporationGroup PAC ID 0648580597, 147 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Carlos Apache Healthcare Corporation Hospital, Peridot, AZ, CCN 031320

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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.

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment Care Compare group NPD
• App of Tennessee Ed, PLLC

  • Emergency Medicine Physician
  • Maryville, TN
  • NPI 1003230236
  Medicare reassignment NPD
• Emergency Coverage, LLC

  dba Emergency Coverage Corporation of TeamHealth

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  Emergency Medicine

  Medicare reassignment NPD
• Trigg County Hospital, Inc

  • Critical Access Hospital
  • Cadiz, KY
  • NPI 1538218680

  Emergency Medicine

  Medicare reassignment NPD
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713
  NPD
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593
  NPD (past)
• Emergency Services Network, PLLC.

  • Emergency Medicine Physician
  • Clarksville, TN
  • NPI 1902852007
  NPD (past)
• Madison Behavioral Health, LLC

  dba Madison Behavioral Health

  • Psychiatry Physician
  • Madison, TN
  • NPI 1891741450
  NPD (past)
• Madison Behavioral Health, LLC

  • Psychiatry Physician
  • Madison, TN
  • NPI 1912938515
  NPD (past)
• TN-I Medical Services PC

  • Physician Assistant
  • Nashville, TN
  • NPI 1972894244
  NPD (past)
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277
  NPD (past)

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

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075
  Care Compare affiliation
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396784138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 WILMA RUDOLPH BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405821",
            "telephone_number": "931-645-1564",
            "fax_number": "931-645-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 WILMA RUDOLPH BLVD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405821",
            "telephone_number": "931-645-1564",
            "fax_number": "931-645-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "RANDALL",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD27444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "4041098",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Ellis
• Amy Leigh Ellis, CPHT
• Gabriel Maxwell Ellis, LPC
• Jennifer Lowe Ellis, M.D.
• Makenzi Ellis
• Roger Terry Ellis, D.D.S.
• Sarah Eisen Ellis, MD
• Angela Mae Ellison, APRN
• Terri Lynn Ellison, MSOT
• Ellen Owen Elmore, O.D.

• Emergency Medicine Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Emergency Medicine Physician in Tennessee

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