Jennifer Lowe Ellis, M.D.

Primary specialty

Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X

License

28060 Issued in TN

Practice address

1539 Ashland City Rd Ste C
Clarksville, TN 37040-6416

Phone

(931) 551-4100

Fax

(931) 551-8710

NPI assigned

Jul 12, 2007

Sex

Female

Sole proprietor

Yes

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 TN

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

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1972702819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 CARRIGAN RD",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438200",
            "telephone_number": "931-551-4100",
            "fax_number": "931-551-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 ASHLAND CITY RD STE C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370406416",
            "telephone_number": "931-551-4100",
            "fax_number": "931-551-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "JENNIFER",
        "middle_name": "LOWE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TN",
            "license": "28060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Ellis
• Amanda Nicole Ellis, MPH. MSW
• Amy Ellis
• Amy Leigh Ellis, CPHT
• Gabriel Maxwell Ellis, LPC
• Makenzi Ellis
• Randall E Ellis, M.D.
• Roger Terry Ellis, D.D.S.
• Sarah Eisen Ellis, MD
• Angela Mae Ellison, RN

• Public Health & General Preventive Medicine Physician in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Public Health & General Preventive Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.