ROBERT ELLIS PA-C NPI 1780278499

NPI Information

  • NPI: 1780278499
  • Provider Name: ROBERT ELLIS, PA-C
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 6025 WALNUT GROVE RD STE 301
    MEMPHIS, TN
    ZIP 38120
  • Phone: (901) 226-0456

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NPI Details

Robert Ellis, PA-C is a surgical physician assistant in Memphis, TN. Robert Ellis, PA-C NPI is 1780278499. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6025 WALNUT GROVE RD STE 301
MEMPHIS, TN
ZIP 38120-123
Phone: (901) 226-0456
Fax: (901) 226-0458

The NPI 1780278499 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 2/23/2021 and was last updated on 2/24/2025.

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
1363AM0700XPhysician AssistantMedicalNo
2363AS0400XPhysician AssistantSurgicalPA00540MISSISSIPPINo
3363AS0400XPhysician AssistantSurgical5490TENNESSEEYes

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: 3/30/2025

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