CAROLYN ELLIS NPI 1104291533

NPI Information

NPI: 1104291533
Provider Name: CAROLYN ELLIS
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
1904 HIGHWAY 46 S
SUITE 3
DICKSON, TN
ZIP 37055
Phone: (615) 375-8469
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Carolyn Ellis is a medical physician assistant in Dickson, TN. Carolyn Ellis NPI is 1104291533. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1904 HIGHWAY 46 S
SUITE 3
DICKSON, TN
ZIP 37055-744
Phone: (615) 375-8469

The NPI 1104291533 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/10/2015 and was last updated on 12/10/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	1087	ALABAMA	No
2	363AM0700X	Physician Assistant	Medical	2879	TENNESSEE	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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