CHAD ELLIS
NPI 1154889996
Physician Assistant - Medical in Charlotte, NC

Q: What is Chad Ellis's NPI number?

The NPI number for Chad Ellis is 1154889996. It was assigned to this individual provider in the NPPES registry on March 12, 2019.

Q: What is Chad Ellis's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Chad Ellis was last updated on March 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 12, 2019PECOS Enrolled

6010 E W T HARRIS BLVD, CHARLOTTE, NC 28215(704) 208-4134 Get Directions Write a Review

NPPES record last updated: March 1, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 1, 2022, Jul 11, 2019, Mar 12, 2019 (3 updates tracked since 2019).

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About Chad Ellis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHAD ELLIS (NPI 1154889996) is an individual medical provider in Charlotte, North Carolina, licensed in North Carolina (0010-08882) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, maintains a secondary practice location in Charlotte, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1154889996

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameCHAD ELLIS

Location Address6010 E W T HARRIS BLVDCharlotte, NC 28215-4084

Mailing Address6010 E W T Harris BlvdCharlotte, NC 28215-4084 · (704) 208-4134

Phone(704) 208-4134

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateMarch 12, 2019

Last NPPES UpdateMarch 1, 20223 updates tracked since enumeration

NPPES CertifiedMarch 1, 2022

✔ NPI 1154889996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in NC · 0010-08882

6010 E W T HARRIS BLVD, Charlotte, NC 28215

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Secondary Practice Location 1

Location 19835 Monroe Rd Ste BCharlotte, NC 28270-1471 · Phone (704) 208-4134

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Chad Ellis is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557603768

PECOS Enrollment IDI20190508001074

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMITY MEDICAL GROUP, INC.

Clinic/Center (Federally Qualified Health Center (FQHC))