NPI age
15 years
Enumerated 2011-03-26
● Active
Type 1 · Individual
Dr. Jack Bradley Ellis, D.O.
Ellis is 1 of 367 internal medicine providers in Augusta and 1 of 5,143 in Georgia.
Primary specialty
Internal Medicine
Plus 1 subspecialty
Licensed in
GA, NU
2 states
Status
Active
No deactivations on record
Last NPPES update
2018-05-31
Source: CMS NPPES provider record
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 5143 active internal medicine providers in Georgia.
NPI age
15 years
↓ 3 yr below median (18 yr)
State licenses
2 states
Top 82% — 17% of peers are multi-state
Subspecialties
1
In the 32% of peers with subspecialties
NPI lifetime · 2011 → 2018
2011-03Enumerated in NPPES
2011
2018
Where they practice
Practice location
1120 15th St
Augusta, GA 30912
Mailing address
1499 Walton Way Ste 1400
Augusta, GA 309012603
Additional practice locations
1 secondary location on file with NPPES.
Location 2
9040 Fitzsimmons Dr
Joint Base Lewis McChord, WA 984311000
Specialties
-
Internal Medicine PrimaryA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
-
Student in an Organized Health Care Education/Training ProgramAn individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Medicare directory context
Medicare specialties
Internal Medicine
Largest Medicare group
3059 members
Largest listed enrollment group
Facility affiliations reported by CMS
- Wellstar Medical Group Llc
Practice context
Part of a multi-provider practice. 1,614 other active providers share this practice address in NPPES.
Recently enumerated nearby: 21 new internal medicine providers have been added in Augusta in the last 180 days.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.