Justin D. Ellis, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

102909 Issued in NC

Practice address

1771 Tate Blvd SE
Suite 201
Hickory, NC 28602-4249

Phone

(828) 324-4804

Fax

(828) 324-7256

NPI assigned

Apr 11, 2006

Last updated

Jun 3, 2015By 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 NC

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

Physician Assistant

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Catawba Valley Medical Group IncGroup PAC ID 6305007279, 133 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Catawba Valley Medical Group, Inc

  dba Catawba Valley Family Care - Catawba

  • Family Medicine Physician
  • Catawba, NC
  • NPI 1790062362
  Medicare reassignment Care Compare group
• DLP Frye Medical Group LLC

  dba FryeCare Lincolnton Medical Group

  • Rural Health Clinic/Center
  • Lincolnton, NC
  • NPI 1154005965
  Medicare reassignment NPD
• Catawba Valley Medical Group Inc

  dba Gastroenterology Associates of Catawba Valley-A

  • Ambulatory Surgical Clinic/Center
  • Hickory, NC
  • NPI 1659267359
  NPD
• Catawba Valley Medical Group,Inc

  dba Catawba Valley Urgent Care-Piedmont

  • Urgent Care Clinic/Center
  • Hickory, NC
  • NPI 1528463213
  NPD
• DLP Frye Medical Group LLC

  dba FryeCare Generations Family Medicine

  • Family Medicine Physician
  • Hickory, NC
  • NPI 1114466802

  Physician Assistant

  NPD
• Hickory Cardiology Associates PLLC

  dba Western Piedmont Heart Centers

  • Cardiovascular Disease Physician
  • Hickory, NC
  • NPI 1083676928
  NPD
• Cardiology Physicians Corporation, LLC

  • Cardiovascular Disease Physician
  • Hickory, NC
  • NPI 1891097473
  NPD (past)

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

• Catawba Valley Medical Center

  • General Acute Care Hospital
  • Hickory, NC
  • NPI 1164495255
  Care Compare affiliation

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1972566651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N CENTER ST",
            "address_2": "SUITE 300",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015057",
            "telephone_number": "828-328-3300",
            "fax_number": "828-328-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 TATE BLVD SE",
            "address_2": "SUITE 201",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286024249",
            "telephone_number": "828-324-4804",
            "fax_number": "828-324-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JUSTIN",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elite Upper Cervical Chiropractic PC
• Suzanne H Eller, LMBT
• Tracy A. Ellingson, CRNA
• Kimberly Elliott, RN, BSN
• Lee Clayton Elliott, MD
• Michelle Lynn Ellis
• Kimberlee Marie Ellison, APRN
• Michelle Hanrahan Ellwanger, LPC
• Michael W Elmore, PHARMD
• William E Elmore, LPA

• Physician Assistant in Hickory, NC
• Providers in Hickory, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.