DR. GLENN THOMAS ELLIS PHD
NPI 1184712820
Psychologist in Columbus, MS

Active since October 10, 2006PECOS EnrolledAccepts Medicare Assignment
815 2ND AVE NO, COLUMBUS, MS 39701(662) 327-7388(662) 329-1177 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Glenn Thomas Ellis Phd NPPES

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

DR. GLENN THOMAS ELLIS PHD (NPI 1184712820) is an individual psychologist in Columbus, Mississippi, licensed in Mississippi (105) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Other (1970).

NPPES Registry Identity

NPI1184712820
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameDR. GLENN THOMAS ELLISCredential: PHD
Location Address815 2ND AVE NOColumbus, MS 39701
Mailing Address815 2nd Ave NorthColumbus, MS 39701 · (662) 327-7388 · Fax (662) 329-1177
Fax(662) 329-1177
Sole ProprietorNo
Medical School CMSOtherGraduated 1970
Enumeration DateOctober 10, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1184712820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MS · 105
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
815 2ND AVE NO, Columbus, MS 39701

Other Identifiers 1

Medicaid00115223MS

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Glenn Thomas Ellis Phd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9234465881
PECOS Enrollment IDI20190927000736
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Glenn Ellis reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Psychiatric/Mental Health
12183 MS HIGHWAY 182 STE 108
Starkville, MS 39759
  • Reassigned Medicare billing, Mississippi enrollment
  • 4 clinicians in this Medicare group
Psychiatry
1203 MEDICAL PARK DR
Oxford, MS 38655
  • Reassigned Medicare billing, Mississippi enrollment
  • 60 clinicians in this Medicare group
Psychiatry
3531 LAKELAND DR STE 1060
Flowood, MS 39232
  • Reassigned Medicare billing, Mississippi enrollment
  • 54 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

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

Counselor (Professional)
815 2ND AVE NO
COLUMBUS, MS 39701

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Glenn Ellis's NPI number?

The NPI number for Glenn Ellis is 1184712820. It was assigned to this individual provider in the NPPES registry on October 10, 2006.

Where is Glenn Ellis located?

Glenn Ellis practices at 815 2nd Ave No, Columbus, MS 39701. The listed phone number is (662) 327-7388.

What is Glenn Ellis's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Glenn Ellis enrolled in Medicare?

Yes. Glenn Ellis is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Glenn Ellis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Glenn Ellis reassigns Medicare benefits to 3 organizations: State Of Mind Psychiatry, LLC (Starkville, MS), Right Track Medical Group, Inc (Oxford, MS) and Precise Clinical Neuroscience Specialists (Flowood, MS). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Glenn Ellis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Glenn Ellis accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list Glenn Ellis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Glenn Ellis was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.