NPI age
19 years
Enumerated 2006-06-15
● Active
Type 1 · Individual
DR. Russell John Ellicott, D.P.M.
Ellicott is 1 of 3 podiatrist providers in Martinez and 1 of 437 in Georgia.
Primary specialty
Podiatrist
Plus 1 subspecialty
Licensed in
GA, SC
2 states
Status
Active
No deactivations on record
Last NPPES update
2019-02-06
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 437 active podiatrist providers in Georgia.
NPI age
19 years
≈ at median (18 yr)
State licenses
2 states
Top 89% — 11% of peers are multi-state
Subspecialties
0
23% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-06Enumerated in NPPES
2006
2026
Where they practice
Practice location
501 Furys Ferry Rd
Martinez, GA 309079059
Mailing address
501 Fury'S Ferry Road
Martinez, GA 30907
Specialties
-
Podiatrist PrimaryA podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00336124A |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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