Gregory Taylor Ellison

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

024806 Issued in GA

Practice address

1430 Harper St
Building B
Augusta, GA 30901-0617

Phone

(706) 724-5451

Fax

(706) 724-9562

NPI assigned

Sep 8, 2005

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 GA

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 1

Medicare enrollment (NPD)

Enrolled

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.

• Augusta Surgical Group, P.C.

  • Surgery Physician
  • Augusta, GA
  • NPI 1275626038
  Medicare reassignment NPD

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1780678516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 HARPER ST",
            "address_2": "BUILDING B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309010617",
            "telephone_number": "706-724-5451",
            "fax_number": "706-724-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 HARPER ST",
            "address_2": "BUILDING B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309010617",
            "telephone_number": "706-724-5451",
            "fax_number": "706-724-9562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "GREGORY",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "024806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G24806",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Ellis
• Shamara Ellis
• Sherell Ellis, LPC; BCBA
• Terry Randal Ellis, DMD
• William John Ellis, ATC
• William Ellisor, RPH, PHARMD
• Ahmed A. Elmarakby, DR.
• Khaled Mosaad Mohamed Arafa Elsakka, MD
• Omar Elsayed, MBBCH
• Ranya Elsayed

• Surgery Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.