Ethan Kellum, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

54782 Issued in TN

Practice address

125 Cool Springs Blvd
Suite 240
Franklin, TN 37067-6474

Phone

(901) 484-0837

NPI assigned

Jun 26, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, AL2 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

Specialty

Orthopedic Surgery

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Regenerative Solutions Sports and Orthopedics, PLLCGroup PAC ID 2062786155, 2 clinicians

Chattanooga Family and Sports Medical Center, PLLCGroup PAC ID 7214094564, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. 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 and National Provider Directory roles.

• Regenerative Solutions Sports and Orthopedics, PLLC

  • Orthopaedic Surgery Physician
  • Franklin, TN
  • NPI 1801335096
  Medicare reassignment Care Compare group NPD Authorized official
• American Wound Care Centers

  • Adult Medicine Physician
  • Brentwood, TN
  • NPI 1306585500
  Medicare reassignment NPD Authorized official
• Chattanooga Family and Sports Medical Center, PLLC

  • Nutrition Chiropractor
  • Chattanooga, TN
  • NPI 1265687917
  Medicare reassignment Care Compare group NPD
• Action Spine & Joint, LLC.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Nashville, TN
  • NPI 1346753837
  Medicare reassignment NPD
• Amg-Southern Tennessee LLC

  • General Practice Physician
  • Winchester, TN
  • NPI 1164789467
  Medicare reassignment NPD
• GK Healthcare Solutions, LLC

  • Physician Assistant
  • Nolensville, TN
  • NPI 1699590661

  AL

  Medicare reassignment NPD
• Awcc

  • Adult Medicine Physician
  • Murfreesboro, TN
  • NPI 1205562279
  NPD Authorized official
• Amg-Southern Tennessee LLC

  • Rural Health Clinic/Center
  • Tullahoma, TN
  • NPI 1174365803
  NPD
• First Choice Integrated Health Care PC

  • General Practice Physician
  • Knoxville, TN
  • NPI 1861054041
  NPD (past)
• Jeff Hall Inc

  • Nutrition Chiropractor
  • Cleveland, TN
  • NPI 1861430753
  NPD (past)
• True Wellness Medical LLC.

  • Multi-Specialty Clinic/Center
  • Chattanooga, TN
  • NPI 1417470501
  NPD (past)
• Archbold Medical Group, Inc.

  • Surgery Physician
  • Thomasville, GA
  • NPI 1831353036
  NPD (past)

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1396907705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1410 RELIANCE DR",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370671793",
            "telephone_number": "901-484-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COOL SPRINGS BLVD",
            "address_2": "SUITE 240",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370676474",
            "telephone_number": "901-484-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLUM",
        "first_name": "ETHAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-26",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME 123920",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "35.129501",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TN",
            "license": "54782",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "54782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maegan Neufeldt Keller
• Ryan Blake Keller, PHARMD
• Mark C Kelley, MD
• Mason Kelley, ATC/L
• Megan Elizabeth Kelley
• Kelly Fisk Counseling, LLC
• Kelly Mingus Speech Pathology LLC
• Allyson Eileen Kelly, DDS
• Amy Kelly, SLP-CCC
• Kathleen Frances Kelly

• Orthopaedic Surgery Physician in Franklin, TN
• Providers in Franklin, TN by specialty
• Orthopaedic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.