Ellis Lamar Wynn IV, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

267591 Issued in MT

Practice address

1139 Picket Fence Dr
Evans, GA 30809-9158

Phone

(229) 854-9517

NPI assigned

Jul 31, 2024

Last updated

Feb 3, 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Billings Clinic Hospital Hospital, Billings, MT, CCN 270004

Medicare enrollment (NPD)

Enrolled

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.

• Billings Clinic

  • Emergency Care Clinic/Center
  • Billings, MT
  • NPI 1326104845
  Medicare reassignment Care Compare group NPD
• Billings Clinic

  • General Practice Physician
  • Billings, MT
  • NPI 1376598714
  NPD
• Billings Clinic

  • Physical Therapist
  • Billings, MT
  • NPI 1740630268
  NPD

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

• Billings Cinic

  • General Acute Care Hospital
  • Bozeman, MT
  • NPI 1215660840
  Care Compare affiliation
• Billings Clinic

  dba Billings Clinic Orthopedics and Sports Medicine

  • Orthopaedic Surgery Physician
  • Billings, MT
  • NPI 1003953589

  Hospital

  Care Compare affiliation
• Billings Clinic

  dba Billings Clinic Heights

  • Family Medicine Physician
  • Billings, MT
  • NPI 1033164447

  Hospital

  Care Compare affiliation
• Billings Clinic

  dba Billings Clinic Endocrinology

  • Endocrinology, Diabetes & Metabolism Physician
  • Billings, MT
  • NPI 1124310537

  Hospital

  Care Compare affiliation
• Billings Clinic

  dba Billings Clinic Hospital

  • General Acute Care Hospital
  • Billings, MT
  • NPI 1265478291
  Care Compare affiliation
• Billings Clinic

  dba Billings Clinic Bozeman

  • Internal Medicine Physician
  • Bozeman, MT
  • NPI 1265648455

  Hospital

  Care Compare affiliation
• Billings Clinic

  • General Practice Physician
  • Billings, MT
  • NPI 1376598714

  Hospital

  Care Compare affiliation
• Billings Clinic

  dba Billings Clinic West

  • Internal Medicine Physician
  • Billings, MT
  • NPI 1871548289

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1801625421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 S CASTLE STONE SQ",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591069724",
            "telephone_number": "229-854-9517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1139 PICKET FENCE DR",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308099158",
            "telephone_number": "229-854-9517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "ELLIS",
        "middle_name": "LAMAR",
        "name_suffix": "IV",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN286537",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MT",
            "license": "267591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Women's Physical Therapy of Evans,Inc.
• Sally Edwards Wood, RN, IBCLC
• Danielle Elise Wortham, P.T.
• William Curtis Wright, DMD
• Andrea Wynkoop, LMSW
• X Factor EMS
• Hemant K. Yagnick, MD
• Yay God Boo Devil LLC (Placidus Health & Wellness)
• Ashlee Nicole Crouse Young, MS, LCPC, LPC
• Gertrude Kile Young, PHARMD

• Certified Registered Nurse Anesthetist in Evans, GA
• Providers in Evans, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.