DR. INGRID A ELLISON (NPI# 1205903556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205903556 |
| Entity Type | Individual |
| Full Name | DR. INGRID A ELLISON |
| Credential | M.D. |
| Practice Address |
4795 Jimmy Lee Smith Pkwy Suite 101 Hiram GA 30141-2792 |
| Practice Telephone | 7702226362 |
| Practice Fax Number | 8665287115 |
| Mailing Telephone | 7702226362 |
| Mailing Fax Number | 8665287115 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2013-02-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 45207 | GA | Eye and Vision Services Providers |
| Y | 156FX1100X |
Technician/Technologist Specialization: Ophthalmic |
45207 | GA | Eye and Vision Services Providers |
| Street Address |
4795 JIMMY LEE SMITH PKWY SUITE 101 |
| City | HIRAM |
| State | GA |
| Zip Code | 30141-2792 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982060976 | Myeyedr. Optometry of Georgia, LLC | Optometrist | 4795 Jimmy Lee Smith Pkwy, Suite 101, Hiram, GA 30141-2792 | 2016-01-07 |
| 1144468281 | Hiram Vision Center, Inc. | Optometrist | 4795 Jimmy Lee Smith Pkwy, Bldg 100 Suite 100, Hiram, GA 30141-2792 | 2009-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801255690 | Belinda Lett Baker | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5316 Jones Reserve Walk, Hiram, GA 30141 | 2016-02-22 |
| 1104213339 | Matthew Lee Estes | Nurse Practitioner | 148 Bill Carruth Pkwy Ste 220, Hiram, GA 30141 | 2015-04-26 |
| 1881088649 | Marietta Eye Clinic, Pa | Optometrist | 47 Highland Pavilion Ct, Suite 101, Hiram, GA 30141 | 2015-03-19 |
| 1902217417 | Hiram Dental Group, PC | Dentist | 5218 Jimmy Lee Smith Parkway, Suite 100, Hiram, GA 30141 | 2014-05-19 |
| 1912340613 | Anuj Patel | Orthopaedic Surgery | 148 Bill Carruth Parkway Suite 120, Hiram, GA 30141 | 2013-04-11 |
| 1619280278 | Thomas Wayne Bloodworth | Obstetrics & Gynecology | 6794 Bill Carruth Parkway, Hiram, GA 30141 | 2010-07-23 |
| 1487970026 | Madelynn Lorraine Speach | Counselor | 44 Darbys Crossing Dr Ste 206c, Hiram, GA 30141 | 2010-04-07 |
| 1679760433 | We Care Md, P.C. | Family Medicine | 5610 Wendy Bagwell Parkway, Suite 103, Hiram, GA 30141 | 2007-09-26 |
| 1811188121 | Holly L Watson | Nurse Practitioner | 156 Hiram Drive, Building B, Hiram, GA 30141 | 2007-08-05 |
| 1285842799 | Restoration Physical Therapy, LLC. | Clinic/Center | 5077 Jimmy Lee Smith Pkwy, Suite 119, Hiram, GA 30141 | 2007-05-18 |
| Find all providers in zip 30141 | ||||
| Taxonomy Code | 156FX1100X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Ophthalmic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356999130 | Anna Mccaskill | Technician/Technologist | 1890 Browning Bend Ct, Dacula, GA 30019-7771 | 2019-08-26 |
| 1093221541 | Jessica Leigh Smith | Technician/Technologist | 439 Fir Rd, Franklin, GA 30217-3976 | 2017-12-20 |
| 1134587801 | Robert Pierpont Taylor | Technician/Technologist | 321 Chinquapin Dr Sw, Marietta, GA 30064-3505 | 2016-02-09 |
| 1194039388 | Jeffrey Lee Jennell | Technician/Technologist | 1 Freedom Way, Augusta, GA 30904-6258 | 2010-07-30 |
| 1801059175 | East Point Eye Clinic PC | Technician/Technologist | 3600 Marketplace Blvd, East Point, GA 30344-8129 | 2008-07-08 |
| 1437352812 | Choi Eye Institute, P.C. | Technician/Technologist | 1107 Memorial Dr, Suite 102, Dalton, GA 30720-8662 | 2007-06-06 |
| 1801956909 | Dixophthal PC | Technician/Technologist | 806 N Jefferson St, Albany, GA 31701-2363 | 2006-12-11 |
| 1710066048 | Dean A Sheldon | Technician/Technologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-11-06 |
| 1538271820 | Donna N Loupe | Technician/Technologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-08-31 |
| 1851308381 | Stephen H Herman | Technician/Technologist | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2006-08-01 |
| Find all providers with the same taxonomy | ||||
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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.