DR. REUBEN KRISTIAN ELLIS (NPI# 1114969110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114969110 |
| Entity Type | Individual |
| Full Name | DR. REUBEN KRISTIAN ELLIS |
| Credential | M.D. |
| Practice Address |
1445 Georgia Ave Ste 3 Macon GA 31201-7612 |
| Practice Telephone | 4782501325 |
| Practice Fax Number | 4782546860 |
| Mailing Telephone | 4782501325 |
| Mailing Fax Number | 4782546860 |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2019-04-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
055819 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 730346684AC | 05 | |
| GA | 730346684Q | 05 | |
| GA | 730346684AA | 05 | |
| GA | 730346684P | 05 | |
| GA | 730346684R | 05 | |
| GA | 730346684AB | 05 | |
| GA | 730346684AD | 05 | |
| GA | 730346684Y | 05 | |
| GA | 730346684Z | 05 | |
| GA | 730346684G | 05 | |
| GA | 730346684K | 05 | |
| GA | 730346684N | 05 | |
| GA | 730346684S | 05 | |
| GA | 730346684U | 05 | |
| GA | 730346684V | 05 | |
| GA | 730346684X | 05 | |
| GA | 730346684T | 05 | |
| GA | 730346684M | 05 | |
| GA | 730346684O | 05 | |
| GA | 730346684W | 05 | |
| GA | 730346684J | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 791 Poplar St, Macon, GA 312012045 | 4048778115 | 6783769182 |
| Street Address |
1445 GEORGIA AVE STE 3 |
| City | MACON |
| State | GA |
| Zip Code | 31201-7612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154676377 | Marc Merched Saad | Internal Medicine | 1445 Georgia Ave Ste 3, Macon, GA 31201-7612 | 2012-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639666340 | Yasameen Emad Muzahim | Internal Medicine | 777 Hemlock Street, Msc 165, Macon, GA 31201 | 2018-04-18 |
| 1952819419 | Putnam Dialysis LLC | Clinic/Center | 657 Hemlock Street, Suite 200, Macon, GA 31201 | 2018-01-18 |
| 1730604331 | Graham Arthur Mercier | Surgery | 169 Ashley Ave., Room 202 Main Hospital Msc 333, Charleston, SC 31201 | 2017-08-04 |
| 1376075705 | Diamond Jude | Internal Medicine | 777 Hemlock Street Msc #104, Macon, GA 31201 | 2017-04-03 |
| 1174055263 | Carol Roobin Bashuk | Hearing Instrument Specialist | 634 First Street, Macon, GA 31201 | 2017-03-29 |
| 1144752411 | Hubert Pare | Student in an Organized Health Care Education/Training Program | 777 Hemlock Street, Msc# 165, Macon, GA 31201 | 2017-03-28 |
| 1548613789 | Michael Daugherty | Counselor | 1873 Hardeman Ave, Suite 1, Macon, GA 31201 | 2016-07-22 |
| 1316317993 | 4front Healthcare of Middle Georgia, LLC | Hospice Care, Community Based | 682 1st St, Macon, GA 31201 | 2015-09-25 |
| 1881073054 | Andrew Lee Drahos | Surgery | 777 Hemlock St # 140, Macon, GA 31201 | 2015-05-21 |
| 1720474158 | April Nicole Colley | Nurse Practitioner | 1014 Forsyth Street, Macon, GA 31201 | 2015-04-13 |
| Find all providers in zip 31201 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861663890 | Middle Ga Nephrology | Internal Medicine | 1122 Gray Highway, Suite 4, Macon, GA 31211-3207 | 2008-03-18 |
| 1609071448 | Kimathi Sipho Ricardo Blackwood | Internal Medicine | 890 Second Street, Suite 201, Macon, GA 31201-6863 | 2007-06-20 |
| 1659439107 | Clement C Nwosu | Internal Medicine | 1122 Gray Hwy, Ste 4, Macon, GA 31211-1869 | 2006-12-05 |
| 1164494696 | Stuart Bursten | Internal Medicine | 165 Emery Hwy Ste 100, Macon, GA 31217 | 2006-02-07 |
| 1962493379 | Mufid Ata Othman | Internal Medicine | 2525 2nd St, Suite 150, Macon, GA 31206-2223 | 2005-11-03 |
| 1376541078 | Azmi A Kabbani | Internal Medicine | 640 Martin Luther King Jr Blvd, Suite 200, Macon, GA 31201-3206 | 2005-07-07 |
| 1154676377 | Marc Merched Saad | Internal Medicine | 1445 Georgia Ave Ste 3, Macon, GA 31201-7612 | 2012-07-14 |
| 1962762708 | Physician Consultants of Georgia | Internal Medicine | 1445 Georgia Ave, Suite 3, Macon, GA 31201-7610 | 2012-05-28 |
| 1225301781 | Middle Georgia Internal Medicine & Kidney Diseases | Internal Medicine | 1122 Gray Hwy, Suite 4, Macon, GA 31211-1869 | 2012-02-14 |
| 1962708891 | Kidney Center of Central Georgia, LLC | Internal Medicine | 2525 2nd St, Suite 150, Macon, GA 31206-2223 | 2011-02-10 |
| Find all providers in MACON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.